Provider Demographics
NPI:1659734101
Name:KNEEMAN, JACOB MORGAN (MD)
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:MORGAN
Last Name:KNEEMAN
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 1:10995 QUIVIRA RD
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1207
Mailing Address - Country:US
Mailing Address - Phone:913-339-9437
Mailing Address - Fax:
Practice Address - Street 1:10995 QUIVIRA RD
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1207
Practice Address - Country:US
Practice Address - Phone:913-339-9437
Practice Address - Fax:913-339-9538
Is Sole Proprietor?:No
Enumeration Date:2016-04-01
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSFG257583207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine