1184730863 NPI number — CHRISTIAN KNECHT M.D.

Table of content: CHRISTIAN KNECHT M.D. (NPI 1184730863)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184730863 NPI number — CHRISTIAN KNECHT M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KNECHT
Provider First Name:
CHRISTIAN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184730863
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/07/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1110 LANCASTER RD STE 3
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40475-8792
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-623-3576
Provider Business Mailing Address Fax Number:
859-624-9682

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1110 LANCASTER RD STE 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40475-8792
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-623-3576
Provider Business Practice Location Address Fax Number:
859-624-9682
Provider Enumeration Date:
08/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  37841 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1203706 . This is a "CHA HEALTH" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 30210 . This is a "BLUEGRASS FAMILY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 611235997G . This is a "HUMANA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: P00009017 . This is a "PALMETTO GBA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 1122500 . This is a "PASSPORT HEALTH PLAN" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000306461 . This is a "ANTHEM" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 0005351745 . This is a "AETNA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 163843500 . This is a "US DEPARTMENT OF LABOR" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 5125820 . This is a "CIGNA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 64064512 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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