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General NPI Number Information
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NPI Number | 1760630388
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Entity Type | Individual
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Provider Name | TAL KLATCHKO D.O.
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Gender | Female
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Dates
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Enumeration Date | 09/08/2008
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Last Update Date | 01/04/2022
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Provider Practice Location Address
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Address Line | 2097 HENRY TECKLENBURG DR SUITE 305 WEST
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City | CHARLESTON
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State | SC
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Zip | 29414-5740
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Country | US
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Telephone | 843-763-3360
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Fax | 843-763-3038
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Provider Business Mailing Address
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Address Line | 2000 HEALTH PARK DR
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City | BRENTWOOD
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State | TN
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Zip | 37027-4692
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Country | US
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Telephone | 615-372-5068
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Fax | 844-687-4017
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 1250
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 1250
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License Number State | SC
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