Individual
MR. MARK ALLAN KNAUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MEDICAL DOCTOR
Contact information
Practice address
5041 DALLAS HWY, SUITE D, POWDER SPRINGS, GA 30127-6458
(770) 427-5467
(770) 427-6340
Mailing address
111 MARBLE MILL RD NW, MARIETTA, GA 30060-1047
(770) 422-1013
(770) 514-5996
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
041328
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070008625
MEDICARE RAILROAD
GA
01
—
52635067
BCBS
GA
Enumeration date
05/03/2006
Last updated
12/07/2011
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