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NPI Code Detail

MEDICARE: DR. CARSON S KLUG PHARMD

MEDICARE: DR. CARSON S KLUG PHARMD
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
1183500000XPharmacist22740IA
2183500000XPharmacist123030MN
3390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1720594799
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CARSON S KLUG PHARMD
Provider Business Mailing Address
First Line : 9200 W WISCONSIN AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53226-3522
Country : US
Telephone Number : 414-805-7455
Fax Number :
Provider Business Practice Location Address
First Line : 9200 W WISCONSIN AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53226-3522
Country : US
Telephone Number : 414-805-7455
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2017
Last Update Date : 04/07/2026

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Directions to “ DR. CARSON S KLUG PHARMD” Practice Location

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