Individual
DR. PAUL D KNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T02929
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
108510
MO BLUE SHIELD
MO
05
—
318604006
—
MO
01
—
81596
ARK BLUE SHIELD
AR
Enumeration date
02/06/2007
Last updated
05/13/2013
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