Basic Information
Provider Information
NPI: 1548473374
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KNOPP
FirstName: JAMES
MiddleName: B
NamePrefix: DR.
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5014 VININGTON PL
Address2:  
City: DUBLIN
State: OH
PostalCode: 430167150
CountryCode: US
TelephoneNumber: 6144839706
FaxNumber:  
Practice Location
Address1: 5100 W BROAD ST
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432281607
CountryCode: US
TelephoneNumber: 6145441000
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/08/2007
LastUpdateDate: 04/20/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/20/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X34008993OHN Allopathic & Osteopathic PhysiciansEmergency Medicine 
207P00000X2616WVY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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