Healthcare Provider Details

I. General information

NPI: 1891082772
Provider Name (Legal Business Name): ZACHARY WILLIAM ABRAHAM KLAASSEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2011
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 15TH ST
AUGUSTA GA
30912-0004
US

IV. Provider business mailing address

1120 15TH ST
AUGUSTA GA
30912-0004
US

V. Phone/Fax

Practice location:
  • Phone: 706-721-2519
  • Fax:
Mailing address:
  • Phone: 706-721-8623
  • Fax: 706-721-1459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number081333
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number081333
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: