Provider Demographics
NPI:1053912543
Name:KNEPFLE, JOHN THOMAS
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:THOMAS
Last Name:KNEPFLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4253 PARKVIEW CT
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:OH
Mailing Address - Zip Code:45103-2790
Mailing Address - Country:US
Mailing Address - Phone:513-835-1708
Mailing Address - Fax:
Practice Address - Street 1:815 CLEPPER LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245-1535
Practice Address - Country:US
Practice Address - Phone:513-753-9280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY016817183500000X
OH03232846183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist