Healthcare Provider Details

I. General information

NPI: 1134462161
Provider Name (Legal Business Name): MATTHEW S KLOCEK MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2013
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 STONEWOOD DR STE 200
WEXFORD PA
15090-7376
US

IV. Provider business mailing address

7000 STONEWOOD DR STE 200
WEXFORD PA
15090-7376
US

V. Phone/Fax

Practice location:
  • Phone: 724-940-4001
  • Fax:
Mailing address:
  • Phone: 724-940-4001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD492474
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: