Provider Demographics
NPI:1013938463
Name:KNAVEL, JAMES L (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:L
Last Name:KNAVEL
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 1:352 PELLER RD
Mailing Address - Street 2:
Mailing Address - City:LAKE GENEVA
Mailing Address - State:WI
Mailing Address - Zip Code:53147-4543
Mailing Address - Country:US
Mailing Address - Phone:262-248-4467
Mailing Address - Fax:
Practice Address - Street 1:352 PELLER RD
Practice Address - Street 2:
Practice Address - City:LAKE GENEVA
Practice Address - State:WI
Practice Address - Zip Code:53147-4543
Practice Address - Country:US
Practice Address - Phone:262-248-4467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI18743207XS0106X
IL207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Not Answered207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30196700Medicaid
WI30196700Medicaid