Provider Demographics
NPI:1427022789
Name:KLOESS, PRICE M (MD)
Entity Type:Individual
Prefix:DR
First Name:PRICE
Middle Name:M
Last Name:KLOESS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:PRICE
Other - Middle Name:M
Other - Last Name:KLOESS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3928 MONTCLAIR RD
Mailing Address - Street 2:STE 100
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35213-2426
Mailing Address - Country:US
Mailing Address - Phone:205-592-3911
Mailing Address - Fax:205-592-3537
Practice Address - Street 1:3928 MONTCLAIR RD
Practice Address - Street 2:STE 100
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35213
Practice Address - Country:US
Practice Address - Phone:205-592-3911
Practice Address - Fax:205-592-3537
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALAL 00012235207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009912198Medicaid
AL51507742Medicare PIN
E90208Medicare UPIN
AL009912198Medicaid
AL4800610001Medicare NSC