Provider Demographics
NPI:1548251341
Name:KNOWLES, ROBERT B (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:B
Last Name:KNOWLES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:421 SEWELL DR
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:TN
Mailing Address - Zip Code:38583-1223
Mailing Address - Country:US
Mailing Address - Phone:931-738-4395
Mailing Address - Fax:931-738-4330
Practice Address - Street 1:435 SEWELL DR
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:TN
Practice Address - Zip Code:38583-1223
Practice Address - Country:US
Practice Address - Phone:931-738-4595
Practice Address - Fax:931-837-4596
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD28675207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNG86994Medicare UPIN
TN3836956Medicare ID - Type Unspecified