Mary Klacik Webster, DO
Student in an Organized Health Care Education/Training Program in Memphis, TN. Individual provider (NPI-1).
NPI number1124762018
StatusActive
Last updated in NPPESJun 22, 2025
Details
- NPI
- 1124762018
- Entity type
- Individual (NPI-1)
- Name
- Mary Klacik Webster
- Credential
- DO
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 26, 2022
- Certification date
- Jun 22, 2025
- Last updated
- Jun 22, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Other names
- Mary Susan Klacik (Former Name)
Practice location
920 Madison Ave Ste 447Memphis, TN 38103-3438
Phone 901-448-5814
Mailing address
920 Madison Ave Ste 447Memphis, TN 38103-3438
Phone 901-448-5814
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