Provider Demographics
NPI:1407834468
Name:KNIPPER, JOSEPH E (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:E
Last Name:KNIPPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:601 W STATE HIGHWAY 6
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-5591
Mailing Address - Country:US
Mailing Address - Phone:254-751-9040
Mailing Address - Fax:254-751-9018
Practice Address - Street 1:601 W STATE HIGHWAY 6
Practice Address - Street 2:SUITE 103
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-5591
Practice Address - Country:US
Practice Address - Phone:254-751-9040
Practice Address - Fax:254-751-9018
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-09
Last Update Date:2010-04-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXH9528207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00L66TOtherPTAN
TX00L66TOtherPTAN