Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 036552 | GA |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 036552 | GA |
NPI | 1194887075 |
---|---|
Provider Name | Stephen Curtiss Klasson |
First Address | Rome, GA 30165-1369 |
Second Address | Rome, GA 30165-1625 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2006 |
Last Update Date | 27/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000532276A | (05) | GA |
F28630 | (02) |