Healthcare Provider Details

I. General information

NPI: 1003235920
Provider Name (Legal Business Name): JOSEPH F KNOCHEL, DPM PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2014
Last Update Date: 04/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 WHIPPLE ST STE 101
PRESCOTT AZ
86301-1713
US

IV. Provider business mailing address

112 WHIPPLE ST STE 101
PRESCOTT AZ
86301-1713
US

V. Phone/Fax

Practice location:
  • Phone: 928-445-1541
  • Fax: 928-445-6235
Mailing address:
  • Phone: 928-445-1541
  • Fax: 928-445-6235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number140
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number140
License Number StateAZ

VIII. Authorized Official

Name: DR. JOSEPH F KNOCHEL
Title or Position: PRESIDENT/OWNER
Credential: DPM
Phone: 928-445-1541