Provider Demographics
NPI:1255679320
Name:KNUTZEN, VICTOR KEITH (MD, FACS, FACOG)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:KEITH
Last Name:KNUTZEN
Suffix:
Gender:
Credentials:MD, FACS, FACOG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3334 BROOKFIELD DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-1962
Mailing Address - Country:US
Mailing Address - Phone:775-742-4203
Mailing Address - Fax:
Practice Address - Street 1:313 PILOT RD STE B
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-3524
Practice Address - Country:US
Practice Address - Phone:725-204-8972
Practice Address - Fax:725-204-9612
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-24
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI8132207Q00000X
AZ76081207Q00000X
NV3703207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine