Provider Demographics
NPI:1649360413
Name:KLAMER, THOMAS WRIGHT (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:WRIGHT
Last Name:KLAMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P O BOX 950202
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0202
Mailing Address - Country:US
Mailing Address - Phone:502-272-5100
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:3991 DUTCHMANS LANE, #103
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-1363
Practice Address - Country:US
Practice Address - Phone:502-897-0635
Practice Address - Fax:502-895-3219
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY186042086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000083614BOtherHUMANA - CTS (NVA)
KY50022186OtherPASSPORT - CTS
KY000000045059OtherANTHEM BCBS
KY020013530OtherRAILROAD MEDICARE
KY101686OtherSIHO - CTS
KY64186042Medicaid
KYP00733101OtherRAILROAD MEDICARE KY
IN100006180Medicaid
KY3690603000OtherPASSPORT ADVTG - CTS
KY000000601041OtherANTHEM - CTS
KY1048788OtherPASSPORT
KY2432216000OtherPASSPORT ADVANTAGE
KY00533096OtherMEDICARE - CTS
KY000083614BOtherHUMANA - CTS (NVA)
IN100006180Medicaid
KY2432216000OtherPASSPORT ADVANTAGE