Healthcare Provider Details

I. General information

NPI: 1700875770
Provider Name (Legal Business Name): ARTHUR KENT KLOES PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2005
Last Update Date: 11/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 HOME ST
GEORGETOWN OH
45121-1407
US

IV. Provider business mailing address

3743 REDTHORNE DR
AMELIA OH
45102-1229
US

V. Phone/Fax

Practice location:
  • Phone: 937-378-7820
  • Fax: 937-378-7815
Mailing address:
  • Phone: 513-767-0700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0003562
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03112134
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26024321A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: