Klismith, Michelle Marie

Klismith, Michelle Marie is an individual health care provider with primary practice located at 15909 Jackson Creek Pkwy , Monument CO 80132-8693. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Klismith, Michelle Marie can be contacted via phone (719) 488-9860.

Contact Information

Primary practice address
15909 Jackson Creek Pkwy Monument CO 80132-8693
Phone: (719) 488-9860
Fax: (719) 488-9868
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 53709 Colorado

Profile Details

NPI number 1437231990
LBN Legal business name Klismith, Michelle Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 20th, 2006
Last updated Feb 16th, 2024 - about last year

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 1437231990 NPPES
Oklahoma MEDICAID 200111620A
Oklahoma MEDICAID 81177836

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