Provider Demographics
NPI:1760457329
Name:KLAASEN, ROBERT V (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:V
Last Name:KLAASEN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4442B LEBANON PIKE
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-1312
Mailing Address - Country:US
Mailing Address - Phone:615-852-5668
Mailing Address - Fax:877-721-8404
Practice Address - Street 1:4442B LEBANON PIKE
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-1312
Practice Address - Country:US
Practice Address - Phone:615-852-5668
Practice Address - Fax:877-721-8404
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01041588A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN080135192OtherRAILROAD MEDICARE #
TNQ087409Medicaid
INF29312Medicare UPIN