Provider Demographics
NPI:1003983727
Name:KNIGHT, JAMES GREGORY (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:GREGORY
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 GLADES RD
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:KY
Mailing Address - Zip Code:40403-1369
Mailing Address - Country:US
Mailing Address - Phone:859-986-0500
Mailing Address - Fax:859-986-0505
Practice Address - Street 1:191 GLADES RD
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:KY
Practice Address - Zip Code:40403-1369
Practice Address - Country:US
Practice Address - Phone:859-986-0500
Practice Address - Fax:859-986-0505
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0101439183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY54006085Medicaid
KY54006085Medicaid