Individual
DR. JASON KEITH KLOPOTOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 BLYTHE BLVD, CHARLOTTE, NC 28203-5812
(704) 377-5772
Mailing address
927 EAST BLVD, CHARLOTTE, NC 28203-5203
(704) 377-5772
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2014-01583
NC
207L00000X
Anesthesiology Physician
52126
KY
390200000X
Student in an Organized Health Care Education/Training Program
4301087429
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300022326
—
IN
05
—
7100580170
—
KY
01
—
K269430-KOHMG
KY MEDICARE
KY
Enumeration date
03/30/2007
Last updated
03/05/2019
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