Provider Demographics
NPI:1962454710
Name:KNOBLOCH, RONALD P (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:P
Last Name:KNOBLOCH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10901 E 48TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74146-5830
Mailing Address - Country:US
Mailing Address - Phone:918-749-8765
Mailing Address - Fax:918-392-2155
Practice Address - Street 1:6801 ROGERS AVE STE 412
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-4067
Practice Address - Country:US
Practice Address - Phone:479-573-3947
Practice Address - Fax:479-478-0548
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2025-12-04
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Provider Licenses
StateLicense IDTaxonomies
ARR4235208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR120106001Medicaid
AR120106001Medicaid
AR120106001Medicaid