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NPI Code Detail

MEDICARE: DR. JEFFREY A. KLOSTERMAN OD

MEDICARE:  DR. JEFFREY A. KLOSTERMAN  OD
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
1152W00000XOptometrist1674DTKY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11720058316OTHERKYINDIVIDUAL NPI
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720058316
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEFFREY A. KLOSTERMAN OD
Provider Business Mailing Address
First Line : 300 SEXTON RD
Second Line :
City : HARRODSBURG
State : KY
Zip : 40330-8939
Country : US
Telephone Number : 859-797-4609
Fax Number :
Provider Business Practice Location Address
First Line : 125 COLLIN DRIVE
Second Line :
City : HARRODSBURG
State : KY
Zip : 40330
Country : US
Telephone Number : 859-734-3697
Fax Number : 859-734-3695
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2006
Last Update Date : 09/03/2020

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Directions to “ DR. JEFFREY A. KLOSTERMAN OD” Practice Location

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