Provider Demographics
NPI:1477820017
Name:A KLAS ASSOCIATION
Entity Type:Organization
Organization Name:A KLAS ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:KLAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-698-6883
Mailing Address - Street 1:1829 BRASSICA LN
Mailing Address - Street 2:BLGD. A
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46217-7095
Mailing Address - Country:US
Mailing Address - Phone:317-698-6883
Mailing Address - Fax:317-708-2695
Practice Address - Street 1:1829 BRASSICA LN
Practice Address - Street 2:BLGD. A
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46217-7095
Practice Address - Country:US
Practice Address - Phone:317-698-6883
Practice Address - Fax:317-708-2695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-28
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01038707A207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty