1063562395 NPI number — DR. JOSHUA CHARLES KLAPOW PH.D.

Table of content: DR. JOSHUA CHARLES KLAPOW PH.D. (NPI 1063562395)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063562395 NPI number — DR. JOSHUA CHARLES KLAPOW PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KLAPOW
Provider First Name:
JOSHUA
Provider Middle Name:
CHARLES
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KLAPOW
Provider Other First Name:
JOSH
Provider Other Middle Name:
C
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PH.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1063562395
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4900 MOUNTAIN VIEW PKWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35244-1932
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-980-1369
Provider Business Mailing Address Fax Number:
205-980-1369

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 VESTAVIA OFFICE PARKWAY
Provider Second Line Business Practice Location Address:
SUITE 3200
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35216-3753
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-822-7349
Provider Business Practice Location Address Fax Number:
205-822-7297
Provider Enumeration Date:
01/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  875 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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