MEDICARE: DR. RONALD P. KNOBLOCH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	R4235	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962454710
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD P. KNOBLOCH M.D.

Provider Business Mailing Address
First Line	:	10901 E 48TH ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74146-5830
Country	:	US
Telephone Number	:	918-749-8765
Fax Number	:	918-392-2155

Provider Business Practice Location Address
First Line	:	6801 ROGERS AVE STE 412
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-4067
Country	:	US
Telephone Number	:	479-573-3947
Fax Number	:	479-478-0548

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	12/04/2025

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