1275647927 NPI number — DR. RYAN M KNOWLES DC

Table of content: DR. RYAN M KNOWLES DC (NPI 1275647927)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275647927 NPI number — DR. RYAN M KNOWLES DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KNOWLES
Provider First Name:
RYAN
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DC
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:
1275647927
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/01/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2834 ACUSHNET AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW BEDFORD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02745-3412
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-998-3001
Provider Business Mailing Address Fax Number:
508-998-1461

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2834 ACUSHNET AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW BEDFORD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02745-3412
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-998-3001
Provider Business Practice Location Address Fax Number:
508-998-1461
Provider Enumeration Date:
08/19/2006

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: 111N00000X , with the licence number:  2217 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 4400529 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2161664 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 797199 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1612379 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 351207 . This is a "HAVARD PILGRIM HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 043472756 . This is a "HEALTH CARE VALUE MANAGEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: B20823201 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: Y36553 . This is a "BCBS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 000000022591 . This is a "BOSTON MEDICAL HEALTH NET" identifier . This identifiers is of the category "OTHER".
  • Identifier: Y39254 . This is a "BCBS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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