Provider Demographics
NPI:1871553842
Name:KNOUSE, ALBERT J JR (MD)
Entity type:Individual
Prefix:
First Name:ALBERT
Middle Name:J
Last Name:KNOUSE
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:7 DOCK HILL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17842-8910
Mailing Address - Country:US
Mailing Address - Phone:570-837-2123
Mailing Address - Fax:570-837-2185
Practice Address - Street 1:46 RED HILL CT
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:PA
Practice Address - Zip Code:17074-8706
Practice Address - Country:US
Practice Address - Phone:717-567-3151
Practice Address - Fax:717-567-7571
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2024-08-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD043663L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
738567Medicare ID - Type Unspecified
F53464Medicare UPIN