Individual
CAMERON D. KNACKSTEDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
715 BROWN ST, ALMA, NE 68920-2132
(308) 928-2103
(308) 928-2560
Mailing address
PO BOX 665, ALMA, NE 68920-0665
(308) 928-2103
(308) 928-2560
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0516910
KS
207Q00000X
Family Medicine Physician
Primary
802
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100229260E
—
KS
05
—
100229260G
—
KS
05
—
100229260H
—
KS
05
—
10025988200
—
NE
05
—
10025988300
—
NE
01
—
102291
BCBS
KS
Enumeration date
05/31/2006
Last updated
07/22/2011
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