Individual
DR. TAL KLATCHKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2097 HENRY TECKLENBURG DR, SUITE 305 WEST, CHARLESTON, SC 29414-5740
(843) 763-3360
(843) 763-3038
Mailing address
2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4692
(615) 372-5068
(844) 687-4017
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
1250
SC
207RP1001X
Pulmonary Disease Physician
1250
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012505
—
SC
01
—
P00799636
RAILROAD MC ID-RSFPN
SC
Enumeration date
09/08/2008
Last updated
01/04/2022
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