MEDICARE: DR. PAUL THOMAS KLAS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	92613	GA
2	207Q00000X	Family Medicine Physician	0101037646	VA
3	207Q00000X	Family Medicine Physician	49962-020	WI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	080183668	OTHER	VA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	076611	OTHER	VA	ANTHEM BLUE CROSS BLUE SH
4	9482244005	OTHER	VA	CIGNA HEALTHCARE
5	142740	OTHER	VA	SOUTHERN HEALTH/COVENTRY
6	45097	OTHER	VA	OPTIMA HEALTH

General Provider Information

NPI Number	:	1316942444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL THOMAS KLAS M.D.

Provider Business Mailing Address
First Line	:	PO BOX 742616
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-2616
Country	:	US
Telephone Number	:	770-219-8420
Fax Number	:	608-775-4429

Provider Business Practice Location Address
First Line	:	1439 JESSE JEWELL PKWY NE STE 102
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30501-3806
Country	:	US
Telephone Number	:	770-219-9445
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	11/16/2022

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Directions to “ DR. PAUL THOMAS KLAS M.D.” Practice Location

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