Provider Demographics
NPI:1073777694
Name:PHILLIP B KLAPPER MD PSC
Entity Type:Organization
Organization Name:PHILLIP B KLAPPER MD PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:B
Authorized Official - Last Name:KLAPPER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:270-759-4811
Mailing Address - Street 1:300 S 8TH ST
Mailing Address - Street 2:STE 304 E
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-2400
Mailing Address - Country:US
Mailing Address - Phone:270-759-4811
Mailing Address - Fax:270-767-3625
Practice Address - Street 1:300 S 8TH ST
Practice Address - Street 2:STE 304 E
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-2400
Practice Address - Country:US
Practice Address - Phone:270-759-4811
Practice Address - Fax:270-767-3625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-13
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY19477207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000047166OtherANTHEM, BLUE CROSS BLUE SHIELD
KY64194772Medicaid
KY409013579OtherRAILROAD
KY409013579OtherRAILROAD
KY1254701Medicare PIN
KYC72220Medicare UPIN