Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | IL | |
N | 207XS0106X | Orthopaedic Hand Surgeon | 18743 | WI |
NPI | 1013938463 |
---|---|
Provider Name | Dr. James L Knavel |
First Address | Lake Geneva, WI 53147-4543 |
Second Address | Lake Geneva, WI 53147-4543 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30196700 | (05) | WI |
B54212 | (02) |