Provider Demographics
NPI:1487996062
Name:KLINGMEYER, DOROTHY MARIE (DO)
Entity type:Individual
Prefix:
First Name:DOROTHY
Middle Name:MARIE
Last Name:KLINGMEYER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 N GREEN ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-2416
Mailing Address - Country:US
Mailing Address - Phone:317-386-5628
Mailing Address - Fax:317-386-5629
Practice Address - Street 1:1080 N GREEN ST
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-2416
Practice Address - Country:US
Practice Address - Phone:317-386-5628
Practice Address - Fax:317-386-5629
Is Sole Proprietor?:No
Enumeration Date:2013-03-21
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02006935A207Q00000X, 204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM