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Individual

DR. PAUL THOMAS KLAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1439 JESSE JEWELL PKWY NE STE 102, GAINESVILLE, GA 30501-3806
(770) 219-9445
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
(608) 775-4429

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101037646
VA
207Q00000X
Family Medicine Physician
49962-020
WI
207Q00000X
Family Medicine Physician
Primary
92613
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
005600944
VA
01
076611
ANTHEM BLUE CROSS BLUE SH
VA
01
080183668
RAILROAD MEDICARE
VA
01
142740
SOUTHERN HEALTH/COVENTRY
VA
01
45097
OPTIMA HEALTH
VA
01
9482244005
CIGNA HEALTHCARE
VA
Enumeration date
06/15/2005
Last updated
11/16/2022
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