Individual
JESSE M. NIEDERKLEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1 MT. CARMEL WAY, PITSBURG, KS 66762
(620) 231-6100
(620) 231-0081
Mailing address
1 MT CARMEL WAY, PITTSBURG, KS 66762-7587
(620) 231-7600
(620) 231-0081
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4543
KS
207L00000X
Anesthesiology Physician
4543
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200654320A
—
KS
Enumeration date
02/08/2010
Last updated
02/04/2016
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