Kenneth J Klak DO LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

34002229 Issued in OH

Legal business name

KENNETH J KLAK DO LLC

Practice address

1440 Rockside Rd
314
Parma, OH 44134-2774

Phone

(440) 799-4433

Fax

(440) 799-4437

NPI assigned

Mar 23, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kenneth Klak, DO

Title

President

Phone

(440) 799-4433

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1269302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279497600000",
    "number": "1992029706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 ROCKSIDE RD",
            "address_2": "314",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441342774",
            "telephone_number": "440-799-4433",
            "fax_number": "440-799-4437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 ROCKSIDE RD",
            "address_2": "314",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441342774",
            "telephone_number": "440-799-4433",
            "fax_number": "440-799-4437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH J KLAK DO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-23",
        "last_updated": "2010-07-19",
        "status": "A",
        "authorized_official_last_name": "KLAK",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-799-4433",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34002229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3034326",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Clark Kelly, CDCA
• James Paul Kelly, RPH
• Kayla Kelly
• Carl L Kendall III
• Lilia L Kennedy
• Kenneth T Kmieck
• Carol Keshock, D.P.M.
• Maureen Catherine Ketz, PHARM.D.
• Abdigadir Khalif
• Dale Kidd, CDCA

• Family Medicine Physician in Parma, OH
• Providers in Parma, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.