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General NPI Number Information
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NPI Number | 1598740961
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Entity Type | Individual
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Provider Name | JOEL D KNERR M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/08/2005
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Last Update Date | 03/06/2017
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Provider Practice Location Address
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Address Line | 290 E THIRD STREET
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City | OTTOVILLE
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State | OH
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Zip | 45876
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Country | US
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Telephone | 419-453-3321
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Fax | 419-453-3323
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Provider Business Mailing Address
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Address Line | PO BOX 249 290 E THIRD STREET
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City | OTTOVILLE
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State | OH
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Zip | 45876
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Country | US
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Telephone | 419-453-3321
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Fax | 419-453-3323
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 35048258
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License Number State | OH
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