Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 01199 | MD |
Y | 222Z00000X | Podiatrist | 01199 | MD |
N | 213ES0103X | Foot & Ankle Surgery | 01199 | MD |
NPI | 1013904788 |
---|---|
Provider Name | Dr. James Joseph Klocek |
First Address | Salisbury, MD 21804-6953 |
Second Address | Salisbury, MD 21804-6953 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2005 |
Last Update Date | 05/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1447442462 | NPI (01) | MD |
328420 | MAMSI (01) | MD |
KCV6 | BC/BS (01) | MD |
U19341 | (02) | MD |