Healthcare Provider Details

I. General information

NPI: 1295914539
Provider Name (Legal Business Name): KLAMP AND COMPANY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2007
Last Update Date: 02/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

746 JEFFERSON AVE STE 104
SCRANTON PA
18510-1624
US

IV. Provider business mailing address

746 JEFFERSON AVE STE 104
SCRANTON PA
18510-1624
US

V. Phone/Fax

Practice location:
  • Phone: 570-346-7422
  • Fax: 570-346-7467
Mailing address:
  • Phone: 570-346-7422
  • Fax: 570-346-7467

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD061283L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. DOUGLAS K KLAMP
Title or Position: PHYSICIAN
Credential: MD
Phone: 570-346-7422