Provider Demographics
NPI:1932191707
Name:KNOEPFLER, DENNIS (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:
Last Name:KNOEPFLER
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 1:211 S CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42345-1203
Mailing Address - Country:US
Mailing Address - Phone:270-377-1950
Mailing Address - Fax:270-377-1953
Practice Address - Street 1:211 S CHERRY ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:KY
Practice Address - Zip Code:42345-1203
Practice Address - Country:US
Practice Address - Phone:270-377-1950
Practice Address - Fax:270-377-1953
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-18
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35050228208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH069413Medicaid
OH15630OtherANTHEM
KY00023OtherMEDICARE PIN (GROUP)
OH311339203-00OtherBWC
KY64070014Medicaid
OH311339203-00OtherBWC
OH0612413Medicare ID - Type Unspecified
OH069413Medicaid