Provider Demographics
NPI:1104012673
Name:RICHARD T KLAPCHAR DO INC
Entity Type:Organization
Organization Name:RICHARD T KLAPCHAR DO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:T
Authorized Official - Last Name:KLAPCHAR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:313-966-9472
Mailing Address - Street 1:PO BOX 673671
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48267-3671
Mailing Address - Country:US
Mailing Address - Phone:313-966-9472
Mailing Address - Fax:313-966-9470
Practice Address - Street 1:4160 JOHN R ST
Practice Address - Street 2:SUITE 1007
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2020
Practice Address - Country:US
Practice Address - Phone:313-966-9472
Practice Address - Fax:313-966-9470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0750692Medicaid
OH0750692Medicaid
MIP35120107Medicare PIN