Healthcare Provider Details

I. General information

NPI: 1598814261
Provider Name (Legal Business Name): RICHARD D KNECHT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 11/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 MAIN STREET
OLATHE CO
81425
US

IV. Provider business mailing address

2233 E MAIN ST BUSINESS OPTIONS MEDICAL BILLING
MONTROSE CO
81401-3831
US

V. Phone/Fax

Practice location:
  • Phone: 970-323-6141
  • Fax: 970-323-6117
Mailing address:
  • Phone: 970-765-0818
  • Fax: 970-497-8410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number6665
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.0057574
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: