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General NPI Number Information
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NPI Number | 1134283104
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Entity Type | Individual
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Provider Name | HENRY M KLOTZ MD
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Gender | Male
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 12/19/2012
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Provider Practice Location Address
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Address Line | 77 NELSON ST SUITE #220
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City | AUBURN
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State | NY
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Zip | 13021-1944
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Country | US
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Telephone | 315-253-5151
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Fax | 315-253-0841
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Provider Business Mailing Address
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Address Line | 17 LANSING ST AUBURN MEMORIAL MEDICAL SERVICES, PC
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City | AUBURN
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State | NY
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Zip | 13021-1983
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Country | US
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Telephone | 315-255-7438
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Fax | 315-255-7099
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 154153
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License Number State | NY
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