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General NPI Number Information
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NPI Number | 1518785088
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Entity Type | Organization
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Legal Business Name | VICTOR KNUTZEN, MD
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Dates
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Enumeration Date | 10/02/2024
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 313 PILOT RD STE B
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City | LAS VEGAS
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State | NV
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Zip | 89119-3524
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Country | US
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Telephone | 725-204-8972
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Fax | 725-204-9612
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Provider Business Mailing Address
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Address Line | 313 PILOT RD STE B
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City | LAS VEGAS
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State | NV
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Zip | 89119-3524
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Country | US
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Telephone | 725-204-8972
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Fax | 725-204-9612
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Authorized Official
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Title or Position | DOCTOR OF MEDICINE
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Name | DR. VICTOR KNUTZEN
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Credential | MD
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Telephone | 725-204-8972
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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