Klyachkin, Michael L
Klyachkin, Michael L is an individual health care provider with primary practice located at 688 Walnut St Ste 200, Macon GA 31201-2677. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Klyachkin, Michael L can be contacted via phone (478) 742-7566.Contact Information
Primary practice address
688 Walnut St Ste 200
Macon GA 31201-2677
Phone: (478) 742-7566
Fax: (478) 743-2804
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | 54760 | Georgia |
Profile Details
| NPI number | 1811976053 |
|---|---|
| LBN Legal business name | Klyachkin, Michael L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 16th, 2006 |
| Last updated | Aug 22nd, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811976053 | NPPES |
| Other | 511I770014 | MEDICARE | |
| MEDICAID | 519931565A | MEDICARE |
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