Provider Demographics
NPI:1558347872
Name:KLIPEC, MARTHA JEAN (MD)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:JEAN
Last Name:KLIPEC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:855 W MAPLE ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:HARTVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44632-9668
Mailing Address - Country:US
Mailing Address - Phone:330-877-3616
Mailing Address - Fax:330-877-1783
Practice Address - Street 1:855 W MAPLE ST
Practice Address - Street 2:SUITE 110
Practice Address - City:HARTVILLE
Practice Address - State:OH
Practice Address - Zip Code:44632-9668
Practice Address - Country:US
Practice Address - Phone:330-877-3616
Practice Address - Fax:330-877-1783
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35055164207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00126114OtherRAILROAD MEDICARE NUMBER
OH0706383Medicaid
OHP00126114OtherRAILROAD MEDICARE NUMBER
OH0615347Medicare PIN