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General NPI Number Information
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NPI Number | 1265425235
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Entity Type | Individual
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Provider Name | JOHN CHRISTIAN KLICK M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/25/2005
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Last Update Date | 03/03/2020
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Provider Practice Location Address
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Address Line | 111 COLCHESTER AVE
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City | BURLINGTON
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State | VT
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Zip | 05401-1473
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Country | US
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Telephone | 802-847-0000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 858 MC A410
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City | HERSHEY
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State | PA
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Zip | 17033-0858
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Country | US
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Telephone | 800-243-1455
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Fax |
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 042894
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD462742
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | MD462742
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | 35.094297
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | MD462742
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License Number State | PA
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Taxonomy #6
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Taxonomy Code | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | 042-0014642
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License Number State | VT
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