Provider Demographics
NPI:1023013752
Name:KNECHT, JAMES DARYL (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DARYL
Last Name:KNECHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1029 KEYSER AVENUE
Mailing Address - Street 2:STE F
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-6239
Mailing Address - Country:US
Mailing Address - Phone:318-238-6001
Mailing Address - Fax:318-238-6002
Practice Address - Street 1:1029 KEYSER AVENUE
Practice Address - Street 2:STE F
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457-6239
Practice Address - Country:US
Practice Address - Phone:318-238-6001
Practice Address - Fax:318-238-6002
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA015058207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2101803Medicaid
LA1319538Medicaid
5DL99Medicare PIN
LA2101803Medicaid
6443890002Medicare NSC
6443890001Medicare NSC
B89615Medicare UPIN
LA53359Medicare ID - Type Unspecified