Individual
JOHN REYNOLDS KNORR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
265 WESTGATE DR, BROCKTON, MA 02301-1817
(800) 258-4674
(508) 897-3198
Mailing address
265 WESTGATE DR, BROCKTON, MA 02301-1817
(800) 258-4674
(508) 897-3198
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
72305
MA
2085R0202X
Diagnostic Radiology Physician
Primary
72305
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110051028A
—
MA
01
—
J12143
BCBS
MA
Enumeration date
07/05/2005
Last updated
12/12/2017
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