Provider Demographics
NPI:1942280185
Name:KNAPP, PHILLIP L (OD)
Entity type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:L
Last Name:KNAPP
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11852 SHAFFER DR
Mailing Address - Street 2:BUILDING M
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-3764
Mailing Address - Country:US
Mailing Address - Phone:303-933-0353
Mailing Address - Fax:
Practice Address - Street 1:11852 SHAFFER DR
Practice Address - Street 2:BUILDING M
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-3764
Practice Address - Country:US
Practice Address - Phone:303-933-0353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-21
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1680152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1942280185OtherNPI PERSOANL
COU56598Medicare UPIN
CO1942280185OtherNPI PERSOANL