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Individual

DOUGLAS WILLIAM KLOTCH

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3450 E FLETCHER AVENUE, SUITE 260, TAMPA, FL 33613
(813) 977-1350
(813) 977-1360
Mailing address
3450 E FLETCHER AVENUE, SUITE 260, TAMPA, FL 33613
(813) 977-1350
(813) 977-1360

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
1410211
NY
207Y00000X
Otolaryngology Physician
Primary
ME55312
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04545
BLUE CROSS BLUE SHIELD
FL
Enumeration date
06/25/2006
Last updated
07/08/2007
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