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General NPI Number Information
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NPI Number | 1790906634
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Entity Type | Individual
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Provider Name | JOSEPH KLEJKA MD
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Gender | Male
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 05/19/2009
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Provider Practice Location Address
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Address Line | 700 CHIEF EDDIE HOFFMAN HIGHWAY
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City | BETHEL
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State | AK
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Zip | 99559-0287
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Country | US
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Telephone | 907-543-6300
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 449
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City | BETHEL
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State | AK
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Zip | 99559-0449
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2923
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License Number State | AK
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35.061305
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License Number State | OH
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