Provider Demographics
NPI:1922096775
Name:KLAUS, JOHN R (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:R
Last Name:KLAUS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 E SPRINGFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-2430
Mailing Address - Country:US
Mailing Address - Phone:610-544-2572
Mailing Address - Fax:
Practice Address - Street 1:327 CURTIS AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5201
Practice Address - Country:US
Practice Address - Phone:410-544-2572
Practice Address - Fax:410-392-4339
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00412213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0505739Medicaid
MDT29786Medicare UPIN
PA0505739Medicaid