Provider Demographics
NPI:1063768877
Name:KNOCHEL, JOHN DAVID (DPM)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DAVID
Last Name:KNOCHEL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16841 N 31ST AVE STE 134
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053-3057
Mailing Address - Country:US
Mailing Address - Phone:623-322-5501
Mailing Address - Fax:623-322-8996
Practice Address - Street 1:16841 N 31ST AVE STE 134
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85053-3057
Practice Address - Country:US
Practice Address - Phone:623-322-5501
Practice Address - Fax:623-322-8996
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0758213ES0103X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ835018Medicaid