Kleinman, Mark Ellsworth

Kleinman, Mark Ellsworth is an individual health care provider with primary practice located at 2412 N John B Dennis Hwy , Kingsport TN 37660-4772. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Retina Specialist. Allopathic & Osteopathic Physicians / Retina Specialist is his primary health care specialty. Kleinman, Mark Ellsworth can be contacted via phone (423) 578-4364.

Contact Information

Primary practice address
2412 N John B Dennis Hwy Kingsport TN 37660-4772
Phone: (423) 578-4364
Fax: (423) 578-4372
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 44136 Kentucky
Allopathic & Osteopathic Physicians / Retina Specialist 207WX0107X 44136 Kentucky

Profile Details

NPI number 1063676310
LBN Legal business name Kleinman, Mark Ellsworth
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 16th, 2008
Last updated Dec 3rd, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063676310 NPPES
Kentucky MEDICAID 7100169870

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