Knowles, Antonio Lavale

Knowles, Antonio Lavale is an sole proprietor health care provider with primary practice located at 5362 Estate Office Dr Suite 1, Memphis TN 38119-3635. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Knowles, Antonio Lavale can be contacted via phone (901) 537-0078.

Contact Information

Primary practice address
5362 Estate Office Dr Suite 1 Memphis TN 38119-3635
Phone: (901) 537-0078
Fax: (901) 537-0096
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 581 Tennessee

Profile Details

NPI number 1124188511
LBN Legal business name Knowles, Antonio Lavale
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 8th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124188511 NPPES
Tennessee MEDICAID 3353517

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