Provider Demographics
NPI:1043209893
Name:KNIGHT, GEORGE F (M D)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:F
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 FRONT AVENUE
Mailing Address - Street 2:SUITE #502
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814
Mailing Address - Country:US
Mailing Address - Phone:208-415-0524
Mailing Address - Fax:208-763-3644
Practice Address - Street 1:601 FRONT AVENUE
Practice Address - Street 2:SUITE #502
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814
Practice Address - Country:US
Practice Address - Phone:208-415-0524
Practice Address - Fax:208-763-3644
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-14
Last Update Date:2009-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00592432085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY50017533OtherPASSPORT-KCR
KY711128690Medicaid
FL05646300001Medicaid
KY3425385000OtherPASSPORT ADVANTAGE
FL14284OtherBCBS
TX196770501Medicaid
KY7100028690OtherKY MEDICAID HEALTH CHOICES
KY91741OtherSIHO-KCR
KY000000548200OtherANTHEM-KCR
OH2810855Medicaid
PA102104820Medicaid
VA1043209893Medicaid
VA1043209893Medicaid
KY7100028690OtherKY MEDICAID HEALTH CHOICES
KY3425385000OtherPASSPORT ADVANTAGE
KY711128690Medicaid
PA102104820Medicaid
OHKN7376381Medicare PIN
VA017336P38Medicare PIN