Provider Demographics
NPI:1760457329
Name:KLAASEN, ROBERT V (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:V
Last Name:KLAASEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1350 E COUNTY LINE RD
Mailing Address - Street 2:SUITE I
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-0873
Mailing Address - Country:US
Mailing Address - Phone:317-887-7736
Mailing Address - Fax:317-887-7787
Practice Address - Street 1:365 E MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1361
Practice Address - Country:US
Practice Address - Phone:317-882-6663
Practice Address - Fax:317-881-8993
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2008-09-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01041588A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN080135192OtherRAILROAD MEDICARE #
IN132440JMedicare ID - Type Unspecified
INF29312Medicare UPIN