Individual
KEITH R KNUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
901 E 86TH ST, INDIANAPOLIS, IN 46240-1807
(317) 844-5500
(317) 573-4230
Mailing address
901 E 86TH ST, INDIANAPOLIS, IN 46240-1807
(317) 844-5500
(317) 573-4230
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
01036083A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000195734
BC/BS#
IN
Enumeration date
06/19/2006
Last updated
10/22/2007
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