Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 30977 | OK |
NPI | 1033194758 |
---|---|
Provider Name | Mr. Joseph Robert Knapik |
First Address | Enid, OK 73701-5804 |
Second Address | Enid, OK 73701-5804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2005 |
Last Update Date | 19/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
130005603 | RAILROAD MEDICARE (01) | OK |