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General NPI Number Information
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NPI Number | 1518952589
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Entity Type | Individual
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Provider Name | DARRELL ALEXANDER KLOTZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/15/2005
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Last Update Date | 04/26/2021
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Provider Practice Location Address
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Address Line | 6035 FAIRVIEW RD
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City | CHARLOTTE
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State | NC
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Zip | 28210-3256
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Country | US
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Telephone | 704-295-3000
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Fax | 704-295-3253
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Provider Business Mailing Address
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Address Line | 6035 FAIRVIEW RD
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City | CHARLOTTE
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State | NC
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Zip | 28210-3256
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Country | US
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Telephone | 704-295-3000
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Fax | 704-295-3253
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 2002-00935
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License Number State | NC
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