Individual
JON KLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1 STADIUM DRIVE, MORGANTOWN, WV 26506
(304) 598-4800
(304) 293-6963
Mailing address
PO BOX 897, MORGANTOWN, WV 26507-0897
(304) 293-7401
(304) 293-6963
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
875
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00452223
RAILROAD MEDICARE
WV
Enumeration date
10/05/2006
Last updated
04/15/2022
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