Doctor Name: | CHAD RANDALL KNIGHT |
NPI Number: | 1750740197 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CRT |
License Number: | 140427 |
Business Practice Address: | 761b Man Bone Creek Rd Whigham, GA - 398972409 |
Business Phone Number: | 2293784242 |
Business Fax Number: | |
Mailing Address: | 761b Man Bone Creek Rd, WHIGHAM |
State: | GA |
Postal Code: | 398972409 |
Phone Number: | 2293784242 |
Fax Number: | |
NPI Enumeration Date: | 02/13/2016 |
NPI Last Update Date: | 02/13/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QS1200X |
License Number: | 140427 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Sleep Disorder Diagnostic |
Taxonomy Definition: |