Provider Demographics
NPI:1104808872
Name:KLINE, GEORGE L JR (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:L
Last Name:KLINE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5 BROWN CT
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07930-2481
Mailing Address - Country:US
Mailing Address - Phone:908-879-1997
Mailing Address - Fax:908-879-6090
Practice Address - Street 1:5 BROWN CT
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:NJ
Practice Address - Zip Code:07930-2481
Practice Address - Country:US
Practice Address - Phone:908-879-1997
Practice Address - Fax:908-879-6090
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA02059200207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2665808Medicaid
NJ2665808Medicaid
NJ010908Medicare ID - Type UnspecifiedPHYSICIAN