Knudson, Gregory J
Knudson, Gregory J is an individual health care provider with primary practice located at 2500 E Enterprise Ave Unit C, Appleton WI 54913. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Knudson, Gregory J can be contacted via phone (920) 739-5642.Contact Information
Primary practice address
2500 E Enterprise Ave Unit C
Appleton WI 54913
Phone: (920) 739-5642
Fax: (920) 968-0259
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 29727 | Wisconsin |
Profile Details
| NPI number | 1457395519 |
|---|---|
| LBN Legal business name | Knudson, Gregory J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 16th, 2006 |
| Last updated | Apr 3rd, 2008 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457395519 | NPPES |
| Wisconsin | MEDICAID | 31529000 |
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