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Individual

DR. KEITH DANIEL KNOPES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5900
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5900

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
20698
MS
207L00000X
Anesthesiology Physician
G87702
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00273269
MS
05
2102397
LA
01
302I059646
MEDICARE PTAN
MS
01
P01250435
RAILROAD MEDICARE
MS
Enumeration date
07/20/2006
Last updated
01/27/2014
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