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General NPI Number Information
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NPI Number | 1073515680
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Entity Type | Individual
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Provider Name | RICHARD WAYNE KLATT DO
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Gender | Male
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Dates
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Enumeration Date | 08/12/2005
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Last Update Date | 11/13/2007
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Provider Practice Location Address
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Address Line | 3150 N TENAYA WAY STE 255
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City | LAS VEGAS
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State | NV
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Zip | 89128-0443
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Country | US
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Telephone | 702-870-2099
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Fax | 702-869-5347
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Provider Business Mailing Address
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Address Line | PO BOX 1737
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City | LAS VEGAS
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State | NV
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Zip | 89125-1737
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Country | US
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Telephone | 702-671-6845
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Fax | 702-671-6883
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 376
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License Number State | NV
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