Doctor Name: | MR. CHARLES ANTHONY KNIGHT |
NPI Number: | 1427303288 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MSOTR/L |
License Number: | KY-R4075 |
Business Practice Address: | 620 John Paul Jones Cir Portsmouth, VA - 237082111 |
Business Phone Number: | 7579537550 |
Business Fax Number: | 7579530090 |
Mailing Address: | 620 John Paul Jones Cir, PORTSMOUTH |
State: | VA |
Postal Code: | 237082111 |
Phone Number: | 7579537550 |
Fax Number: | 7579530090 |
NPI Enumeration Date: | 07/18/2012 |
NPI Last Update Date: | 07/18/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171000000X |
License Number: | KY-R4075 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Military Health Care Provider |
Taxonomy Specialization: | |
Taxonomy Definition: | Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |