Healthcare Provider Details

I. General information

NPI: 1245562768
Provider Name (Legal Business Name): JOSEPH E. KNOCHEL, DPM PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2010
Last Update Date: 02/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 WHIPPLE ST SUITE 101
PRESCOTT AZ
86301-1713
US

IV. Provider business mailing address

112 WHIPPLE ST SUITE 101
PRESCOTT AZ
86301-1713
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH E KNOCHEL
Title or Position: OWNER
Credential: DPM
Phone: 928-445-1541