Provider Demographics
NPI:1730185430
Name:KLAG, JOSEPH V (DO)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:V
Last Name:KLAG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 98819
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89193
Mailing Address - Country:US
Mailing Address - Phone:602-494-3659
Mailing Address - Fax:602-494-3682
Practice Address - Street 1:3805 E BELL RD
Practice Address - Street 2:SUITE 3100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032
Practice Address - Country:US
Practice Address - Phone:602-867-8644
Practice Address - Fax:602-795-5698
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ3185207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1Z3959OtherHEALTHNET
AZ25-00208OtherUNITED HEALTHCARE
AZ060042204OtherRAILROAD MEDICARE
AZ391045Medicaid
AZAZ0814020OtherBLUE CROSS BLUE SHIELD
AZ391045Medicaid
AZAZ0814020OtherBLUE CROSS BLUE SHIELD