Healthcare Provider Details

I. General information

NPI: 1245345958
Provider Name (Legal Business Name): CHARLES ROY KLEPPER ET AL PTRS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 04/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 N MAIN ST
HARRISON AR
72601-2912
US

IV. Provider business mailing address

707 N MAIN ST
HARRISON AR
72601-2912
US

V. Phone/Fax

Practice location:
  • Phone: 870-741-3592
  • Fax: 870-741-7733
Mailing address:
  • Phone: 870-741-3592
  • Fax: 870-741-7733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHARLES R. KLEPPER
Title or Position: OWNER
Credential: M.D.
Phone: 870-741-3592