Individual
LISA CAROLINE KLEPCZYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1968 PEACHTREE RD NW, RADIATION ONCOLOGY DEPT, ATLANTA, GA 30309-1281
(404) 605-4227
(770) 916-3343
Mailing address
1968 PEACHTREE RD NW, RADIATION ONCOLOGY DEPT, ATLANTA, GA 30309-1281
(404) 605-4227
(770) 916-3343
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
036163337
IL
2085R0001X
Radiation Oncology Physician
072012
GA
2085R0001X
Radiation Oncology Physician
29795
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003148167B
—
GA
01
—
0366100001
MC NSC
AL
01
—
102I926603
MEDICARE PTAN
AL
05
—
148843
—
AL
01
—
202I928503
MEDICARE PTAN
GA
01
—
511-36409
BCBS
AL
Enumeration date
06/19/2008
Last updated
04/10/2023
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