Provider Demographics
NPI:1043212293
Name:KNOX, DOUGLAS B (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:B
Last Name:KNOX
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12105 REINHARDT LN
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66209-2113
Mailing Address - Country:US
Mailing Address - Phone:913-696-0835
Mailing Address - Fax:
Practice Address - Street 1:1010 CARONDELET DR
Practice Address - Street 2:STE 140
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-4821
Practice Address - Country:US
Practice Address - Phone:816-943-0199
Practice Address - Fax:816-943-0323
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2023-05-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO106993207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F85649Medicare UPIN