Organization
TRENT E. KNEWTSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHERRIE J. KRAMER (OFFICE MANAGER)
(913) 294-2305
Entity
Organization
Contact information
Practice address
705 BAPTISTE DR, PAOLA, KS 66071-1336
(913) 294-2305
(913) 294-5403
Mailing address
PO BOX 298, PAOLA, KS 66071-0298
(913) 294-2305
(913) 294-5403
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
529059
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100866
KANSAS BLUE SHIELD
—
01
—
1982693503
NPI
KS
01
—
29201011
MISSOURI BLUE SHIELD
KS
01
—
529059
STATE LICENSE
KS
01
—
621111
NAICS
KS
Enumeration date
10/10/2007
Last updated
03/07/2023
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