Provider Demographics
NPI:1063517308
Name:KLEEMAN, ERIC F (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:F
Last Name:KLEEMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 7TH ST
Mailing Address - Street 2:
Mailing Address - City:TELL CITY
Mailing Address - State:IN
Mailing Address - Zip Code:47586-2202
Mailing Address - Country:US
Mailing Address - Phone:812-547-9663
Mailing Address - Fax:812-547-1300
Practice Address - Street 1:421 7TH ST
Practice Address - Street 2:
Practice Address - City:TELL CITY
Practice Address - State:IN
Practice Address - Zip Code:47586-2202
Practice Address - Country:US
Practice Address - Phone:812-547-9663
Practice Address - Fax:812-547-1300
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01061167A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200538280Medicaid
KY64111198Medicaid
INI45590Medicare UPIN
IN251770Medicare PIN