Provider Demographics
NPI:1861427379
Name:KNECHT, CRAIG L (MD)
Entity type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:L
Last Name:KNECHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 949
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37077-0949
Mailing Address - Country:US
Mailing Address - Phone:615-264-3200
Mailing Address - Fax:615-264-1410
Practice Address - Street 1:353 NEW SHACKLE ISLAND RD
Practice Address - Street 2:SUITE 101 A
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-2379
Practice Address - Country:US
Practice Address - Phone:615-264-3200
Practice Address - Fax:615-264-1410
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD017094207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CSP042OtherCIGNA HEALTH PLAN
TN3150532OtherBLUE CROSS BLUE SHIELD
TN3022559Medicaid
A98649Medicare UPIN
TN3022559Medicare ID - Type Unspecified