Doctor Name: | WILLIAM JOSEPH KINDERKNECHT |
NPI Number: | 1821407644 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DO |
License Number: | |
Business Practice Address: | 4 E. Clark Bass Blvd. Suite 301a Mcalester, OK - 74501 |
Business Phone Number: | 9184216795 |
Business Fax Number: | 9184216791 |
Mailing Address: | 806 Highway 2 N, Suite 301a WILBURTON |
State: | OK |
Postal Code: | 745783625 |
Phone Number: | 9184216795 |
Fax Number: | 9184216791 |
NPI Enumeration Date: | 08/06/2014 |
NPI Last Update Date: | 03/15/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OK |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |