Individual
MR. ANDREW MICHAEL KLAUSING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
801 PRO DR STE D4, CELINA, OH 45822-3307
(419) 586-6480
(419) 586-4125
Mailing address
200 SAINT CLAIR AVE, SAINT MARYS, OH 45885-2400
(419) 300-1129
(419) 394-9575
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.002892RX
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0075276
—
OH
01
—
0105065
JTDM FAMILY PRACTICE, LLC GROUP MEDICAID
OH
01
—
1184652539
JTDM FAMILY PRACTICE, LLC GROUP NPI
OH
01
—
34-1689161
JTDM FAMILY PRACTICE, LLC TAX ID
OH
01
—
9934723
JTDM FAMILY PRACTICE, LLC GROUP MEDICARE PTAN
OH
01
—
H409552
MEDICARE PTAN
—
Enumeration date
03/24/2009
Last updated
08/07/2020
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