Provider Demographics
NPI:1194021147
Name:GEORGE M KNEFELY MD PA
Entity Type:Organization
Organization Name:GEORGE M KNEFELY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KVARTEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-433-3186
Mailing Address - Street 1:14 W JORDAN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-1736
Mailing Address - Country:US
Mailing Address - Phone:850-433-3186
Mailing Address - Fax:850-433-5351
Practice Address - Street 1:14 W JORDAN ST
Practice Address - Street 2:SUITE A
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-1736
Practice Address - Country:US
Practice Address - Phone:850-433-3186
Practice Address - Fax:850-433-5351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-08
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty