Provider Demographics
NPI:1760589378
Name:KNORPP, SCOTT W (MD)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:W
Last Name:KNORPP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:488 E WINCHESTER STREET
Mailing Address - Street 2:SUITE # 160
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107
Mailing Address - Country:US
Mailing Address - Phone:801-281-9808
Mailing Address - Fax:801-281-9860
Practice Address - Street 1:488 E WINCHESTER STREET
Practice Address - Street 2:SUITE # 160
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107
Practice Address - Country:US
Practice Address - Phone:801-281-9808
Practice Address - Fax:801-281-9860
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-19
Last Update Date:2013-12-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT178766-1205208100000X
UT1787661205208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
E92103Medicare UPIN