Provider Demographics
NPI:1528351574
Name:KIRK F KNECHT LLC
Entity type:Organization
Organization Name:KIRK F KNECHT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:KNECHT
Authorized Official - Suffix:
Authorized Official - Credentials:ANP-BC
Authorized Official - Phone:337-277-9913
Mailing Address - Street 1:203 SUMMER MORNING CT
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-7216
Mailing Address - Country:US
Mailing Address - Phone:337-277-9913
Mailing Address - Fax:337-856-1465
Practice Address - Street 1:213 FOURPARK RD STE C
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70507-2481
Practice Address - Country:US
Practice Address - Phone:337-896-6440
Practice Address - Fax:337-896-6441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-24
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care