Knutson, Nickey Glenn

Knutson, Nickey Glenn is an individual health care provider with primary practice located at 8100 S Walker Ave Bldg A, Suite 230, Oklahoma City OK 73139-9402. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Knutson, Nickey Glenn can be contacted via phone (405) 631-0481.

Contact Information

Primary practice address
8100 S Walker Ave Bldg A, Suite 230 Oklahoma City OK 73139-9402
Phone: (405) 631-0481
Fax: (405) 631-9025
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 10530 Oklahoma

Profile Details

NPI number 1558328559
LBN Legal business name Knutson, Nickey Glenn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2006
Last updated Jul 8th, 2007 - about 17 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 1558328559 NPPES
Oklahoma Other 731135951001 BLUE CROSS/BLUE SHIELD

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