Provider Demographics
NPI:1245562768
Name:JOSEPH E. KNOCHEL, DPM PC
Entity Type:Organization
Organization Name:JOSEPH E. KNOCHEL, DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:E
Authorized Official - Last Name:KNOCHEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:928-445-1541
Mailing Address - Street 1:112 WHIPPLE ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-1713
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:112 WHIPPLE ST
Practice Address - Street 2:SUITE 101
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-1713
Practice Address - Country:US
Practice Address - Phone:928-445-1541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric