Individual
JAMES BLAKE KNUTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 510-1186
(903) 525-1254
Mailing address
PO BOX 5500, TYLER, TX 75712-5500
(903) 324-6400
(903) 593-7852
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M1841
TX
208M00000X
Hospitalist Physician
M1841
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
177134701
—
TX
05
—
177134702
—
TX
01
—
1F8734
MEDICARE
TX
Enumeration date
02/15/2006
Last updated
05/18/2023
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