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General NPI Number Information
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NPI Number | 1922001635
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Entity Type | Individual
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Provider Name | WILLIAM JOSEPH KLONTZ MD
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Gender | Male
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 03/13/2015
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Provider Practice Location Address
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Address Line | 5615 W 32ND ST
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City | JOPLIN
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State | MO
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Zip | 64804-8161
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Country | US
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Telephone | 417-627-8400
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Fax | 417-623-1787
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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 | 417-627-8400
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Fax | 417-623-1787
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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 | 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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