KLOCKOW PC (NPI# 1861861254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861861254 |
| Entity Type | Organization |
| Organization Name | KLOCKOW PC |
| Practice Address |
118 S Van Rensselaer St Rensselaer IN 47978-2815 |
| Practice Telephone | 2198691097 |
| Practice Fax Number | 2192671729 |
| Mailing Telephone | 2198691097 |
| Mailing Fax Number | 2192671729 |
| Enumeration Date | 2015-09-16 |
| Last Update Date | 2015-09-16 |
| Authorized Official Name | DR. RAYMOND GORDON KLOCKOW (PRESIDENT) |
| Authorized Official Telephone | 2198691097 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
54000437A | IN | Ambulatory Health Care Facilities |
| Street Address |
118 S VAN RENSSELAER ST |
| City | RENSSELAER |
| State | IN |
| Zip Code | 47978-2815 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679710107 | Gordon P. Bausman | Dentist | 210 N. Front St., Rensselaer, IN 47978 | 2009-01-21 |
| 1669534962 | Stuart A Sandler | Family Medicine | 919 Grace Street, Rensselaer, IN 47978 | 2006-12-14 |
| 1225103146 | Jerry Lynn Markley | Chiropractor | 311 Drexel Parkway, Suite # 1, Rensellaer, IN 47978 | 2006-11-24 |
| 1538262225 | Hook Superx LLC | Durable Medical Equipment & Medical Supplies | 107 N Cullen St, Rensselaer, IN 47978 | 2006-09-07 |
| 1609477793 | Donald Lowell Rusk | Pharmacist | Walmart, 905 S College Ave, Rensselaer, IN 47978 | 2020-11-04 |
| 1235689480 | Jasper County After Hours Urgent Care Inc | Clinic/Center | 716 S College Ave, Rensselaer, IN 47978 | 2016-10-12 |
| 1407230501 | Grainne O' Malley | Internal Medicine | 118 W Drexel Pkwy, Rensselaer, IN 47978 | 2015-07-17 |
| 1972916997 | Joseph Thomas Varnau | Family Medicine | 1104 E Grace St, Rensselaer, IN 47978 | 2014-06-06 |
| 1477812956 | Kirk Jihyon Pak | Internal Medicine | 1104 E Grace St, Rensselaer, IN 47978 | 2012-05-03 |
| 1104197326 | Julian Ungar-sargon Md Phd | Pain Medicine | 123 S Mckinley Ave, Rensselaer, IN 47978 | 2012-01-19 |
| Find all providers in zip 47978 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215409685 | Rensselaer Family Dentistry | Clinic/Center | 210 N Front St, Rensselaer, IN 47978-2620 | 2018-12-26 |
| 1184006777 | Steven M Kosoff Dds Pllc | Clinic/Center | 1 Agway Dr, Rensselaer, NY 12144-9637 | 2015-06-19 |
| 1841458916 | Jordan J Balvich, Dmd, PC | Clinic/Center | 129 N Van Rensselaer St, Rensselaer, IN 47978-2651 | 2008-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720147 | Ms Vibbert Dds PC | Clinic/Center | 7301 Georgetown Rd Ste 113, Indianapolis, IN 46268-4157 | 2020-11-05 |
| 1508471814 | White River Family Dental and Implant Center | Clinic/Center | 1638 W Smith Valley Rd Ste B, Greenwood, IN 46142-1550 | 2020-09-14 |
| 1669087144 | Babb Dentistry LLC | Clinic/Center | 2229 W Virginia St, Evansville, IN 47712-5214 | 2020-09-11 |
| 1790398451 | Bryant P. Burkett Dds, LLC | Clinic/Center | 5310 Pearl Dr Ste C, Evansville, IN 47712-8105 | 2020-08-24 |
| 1508478298 | Verity Smile Studio, LLC | Clinic/Center | 1619 W. 86th St Suite B, Indianapolis, IN 46260 | 2020-08-23 |
| 1831701044 | Tree of Life LLC | Clinic/Center | 311 Florence Ave, Granger, IN 46530-8049 | 2020-08-19 |
| 1568073096 | Fdg Mobile | Clinic/Center | 438 S Emerson Ave Ste 231, Greenwood, IN 46143-1948 | 2020-08-10 |
| 1992315980 | Kaszuba Dental, LLC | Clinic/Center | 1934 45th St, Munster, IN 46321-3917 | 2020-08-04 |
| 1205454014 | Advanced Dental Care of Fortville, LLC | Clinic/Center | 545 Vitality Dr Ste F, Fortville, IN 46040-1373 | 2020-07-08 |
| 1366066375 | Jindal Management LLC | Clinic/Center | 701 N Weinbach Ave Ste 910, Evansville, IN 47711-6607 | 2020-06-05 |
| Find all providers with the same taxonomy | ||||
| City | RENSSELAER |
| Zip Code | 47978 |
Please comment or provide details below to improve the information on KLOCKOW PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.