Individual
GARY L KNEPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
400 N JEFFERSON ST, LEWISBURG, WV 24901
(304) 645-3220
(304) 645-4103
Mailing address
400 N JEFFERSON ST, LEWISBURG, WV 24901
(304) 645-3220
(304) 645-4103
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
036070966
IL
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
2223
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36070966
—
IL
05
—
3810009549
—
WV
01
—
794717
HEALTH ALLIANCE
IL
Enumeration date
06/14/2006
Last updated
08/25/2008
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