Provider Demographics
NPI:1699893065
Name:MID-AMERICA ORTHOPEDIC INSTITUTE
Entity type:Organization
Organization Name:MID-AMERICA ORTHOPEDIC INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHOPEDIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:KLINE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:660-665-7008
Mailing Address - Street 1:1905 S HIGH ST
Mailing Address - Street 2:
Mailing Address - City:KIRKSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63501-4764
Mailing Address - Country:US
Mailing Address - Phone:660-665-7008
Mailing Address - Fax:660-665-0331
Practice Address - Street 1:1905 S HIGH ST
Practice Address - Street 2:
Practice Address - City:KIRKSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63501-4764
Practice Address - Country:US
Practice Address - Phone:660-665-7008
Practice Address - Fax:660-665-0331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR5P98207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty