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General NPI Number Information
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NPI Number | 1871568188
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Entity Type | Organization
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Legal Business Name | WILLIAM J. KLONTZ M.D. INC.
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Dates
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Enumeration Date | 02/21/2006
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Last Update Date | 09/17/2007
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Provider Practice Location Address
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Address Line | 1905 W 32ND ST STE 208
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City | JOPLIN
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State | MO
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Zip | 64804-1529
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Country | US
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Telephone | 417-781-7337
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Fax | 417-781-9093
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Provider Business Mailing Address
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Address Line | 4119 WOODCREST CT
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City | JOPLIN
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State | MO
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Zip | 64804-4567
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Country | US
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Telephone | 417-781-7337
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Fax | 417-781-9093
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM J KLONTZ
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Credential | M.D.
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Telephone | 417-781-7337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | R4D32
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License Number State | MO
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