Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 08000699A | IN |
NPI | 1386617769 |
---|---|
Provider Name | Dr. Christopher J. Klaes |
First Address | Seymour, IN 47274-0747 |
Second Address | Seymour, IN 47274-2224 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2006 |
Last Update Date | 28/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100333400A | (05) | IN |
T34722 | (02) | IN |