MEDICARE: DR. KATHERINE ANN KLOPFER O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	0618001128	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DQ5425	OTHER	VA	MEDICARE RAILROAD CARRIER GROUP
2	P00851698	OTHER	VA	MEDICARE RAILROAD CARRIER

General Provider Information

NPI Number	:	1396805784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHERINE ANN KLOPFER O.D.

Provider Business Mailing Address
First Line	:	32345 CONSTITUTION HWY
Second Line	:
City	:	LOCUST GROVE
State	:	VA
Zip	:	22508-8616
Country	:	US
Telephone Number	:	540-854-0225
Fax Number	:

Provider Business Practice Location Address
First Line	:	32345 CONSTITUTION HWY
Second Line	:
City	:	LOCUST GROVE
State	:	VA
Zip	:	22508-2745
Country	:	US
Telephone Number	:	540-854-0225
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2006
Last Update Date	:	02/10/2011

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