Provider Demographics
NPI:1700050309
Name:KLIMA, BRIAN TODD
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:TODD
Last Name:KLIMA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:NO
Other - Middle Name:OTHER
Other - Last Name:NAME
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1 HEALTHY PL STE 203
Mailing Address - Street 2:
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-7067
Mailing Address - Country:US
Mailing Address - Phone:220-564-1925
Mailing Address - Fax:220-564-1926
Practice Address - Street 1:1 HEALTHY PL STE 203
Practice Address - Street 2:
Practice Address - City:PATASKALA
Practice Address - State:OH
Practice Address - Zip Code:43062-7067
Practice Address - Country:US
Practice Address - Phone:220-564-1925
Practice Address - Fax:220-564-1926
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35091233208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2872897Medicaid