Basic Information
Provider Information
NPI: 1194051714
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KLEE
FirstName: MATTHEW
MiddleName: G
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2620 EAST BARNETT RD
Address2: SUITE H
City: MEDFORD
State: OR
PostalCode: 97504
CountryCode: US
TelephoneNumber: 5417895250
FaxNumber: 5417895538
Practice Location
Address1: 2825 EAST BARNETT RD
Address2:  
City: MEDFORD
State: OR
PostalCode: 97504
CountryCode: US
TelephoneNumber: 5417897000
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/02/2009
LastUpdateDate: 03/11/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/11/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0200XMD158404ORY Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
207R00000XMD15022ORN Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000X51504MNN Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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