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NPI Code Detail

MEDICARE: MR. SCOTT KNUTSON DPM

MEDICARE:  MR. SCOTT  KNUTSON  DPM
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
1213E00000XPodiatrist427MN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
20808750001OTHERMNMEDICARE DMERC
6C02581OTHERMNMEDICARE GROUP
7P00309735OTHERMNMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4480000572OTHERMNTRAVELERS RAILROAD
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8CS1038OTHERMNTRAVELERS RAILROAD GROUP

General Provider Information

NPI Number : 1679578157
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SCOTT KNUTSON DPM
Provider Business Mailing Address
First Line : 6625 LYNDALE AVE S STE 300
Second Line :
City : RICHFIELD
State : MN
Zip : 55423-2491
Country : US
Telephone Number : 612-788-8778
Fax Number : 612-869-3473
Provider Business Practice Location Address
First Line : 6625 LYNDALE AVE S STE 105
Second Line :
City : RICHFIELD
State : MN
Zip : 55423-2673
Country : US
Telephone Number : 612-788-8778
Fax Number : 612-869-3473
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2005
Last Update Date : 07/22/2019

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Directions to “ MR. SCOTT KNUTSON DPM” Practice Location

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