Provider Demographics
NPI:1356398689
Name:KLEPACKI, THOMAS M (DO)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:M
Last Name:KLEPACKI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:41 WELLINGTON DR
Mailing Address - Street 2:
Mailing Address - City:EAST LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01028-2603
Mailing Address - Country:US
Mailing Address - Phone:413-538-6213
Mailing Address - Fax:
Practice Address - Street 1:1221 MAIN STREET
Practice Address - Street 2:WESTERN REGIONAL/MEDICAL EXAMINER
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040
Practice Address - Country:US
Practice Address - Phone:413-538-6213
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA152952207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine