Individual
MR. STEPHEN JOHN KNOBLE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
608 E GARFIELD AVE, GETTYSBURG, SD 57442-1325
(605) 765-2273
(605) 765-2273
Mailing address
306 S BROADWAY ST, GETTYSBURG, SD 57442-1506
(605) 765-2790
(605) 765-2273
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0290
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4997560
INDIVIDUAL BCBS
SD
01
—
4997849
GROUP BCBS
SD
05
—
5350190
—
SD
01
—
57584
MEDICARE B INDIVIDUAL #
SD
05
—
6822152
—
SD
01
—
S6960
BCBS GROUP #
SD
Enumeration date
07/26/2005
Last updated
07/09/2007
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