Provider Demographics
NPI:1710213285
Name:KIM M. CLABBERS, MD PC
Entity type:Organization
Organization Name:KIM M. CLABBERS, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:M
Authorized Official - Last Name:CLABBERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-785-9788
Mailing Address - Street 1:501 BATH RD
Mailing Address - Street 2:SUITE 2F
Mailing Address - City:BRISTOL
Mailing Address - State:PA
Mailing Address - Zip Code:19007-3101
Mailing Address - Country:US
Mailing Address - Phone:215-785-9788
Mailing Address - Fax:
Practice Address - Street 1:120 W MAPLE AVE
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-2820
Practice Address - Country:US
Practice Address - Phone:215-785-9788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-19
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD063354L207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty