Provider Demographics
NPI:1689776148
Name:KNAPP, MICHAEL GERALD (DO)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:GERALD
Last Name:KNAPP
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:601 S SCHIFFERDECKER AVE
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64801-3320
Mailing Address - Country:US
Mailing Address - Phone:417-781-1929
Mailing Address - Fax:417-781-5636
Practice Address - Street 1:601 S SCHIFFERDECKER AVE
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64801-3320
Practice Address - Country:US
Practice Address - Phone:417-781-1929
Practice Address - Fax:417-781-5636
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-03
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR1B60204D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM