Provider Demographics
NPI:1881713055
Name:KNUTSON, JOHN F (PHD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:KNUTSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3084 HIGHWAY 1 NE
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-7730
Mailing Address - Country:US
Mailing Address - Phone:319-351-6963
Mailing Address - Fax:
Practice Address - Street 1:11 SEASHORE HALL E
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1407
Practice Address - Country:US
Practice Address - Phone:319-335-2467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00218103TC0700X
WI1017103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA29098OtherPROVIDER NUMBER