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:
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Health care specialties

SpecialtyCodeLicense #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 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811976053 NPPES
Other 511I770014 MEDICARE
MEDICAID 519931565A MEDICARE

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