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NPI Code Detail

MEDICARE: DR. CRAIG CHARLES KNETEN MD

MEDICARE:  DR. CRAIG CHARLES KNETEN  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianK2729TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043278815
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CRAIG CHARLES KNETEN MD
Provider Business Mailing Address
First Line : 900 W MAGNOLIA AVE
Second Line : SUITE 201
City : FORT WORTH
State : TX
Zip : 76104-8517
Country : US
Telephone Number : 817-921-6166
Fax Number : 817-921-9594
Provider Business Practice Location Address
First Line : 1650 W MAGNOLIA AVE
Second Line : SUITE 202
City : FORT WORTH
State : TX
Zip : 76104-4009
Country : US
Telephone Number : 817-922-7800
Fax Number : 817-922-7801
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2006
Last Update Date : 07/24/2009

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Directions to “ DR. CRAIG CHARLES KNETEN MD” Practice Location

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