Provider Demographics
NPI:1073617403
Name:KNIGHT, PATRICK LANE
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:LANE
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2941 WALDROP RD
Mailing Address - Street 2:
Mailing Address - City:ASHVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35953
Mailing Address - Country:US
Mailing Address - Phone:205-472-0042
Mailing Address - Fax:
Practice Address - Street 1:800 NOBLE ST
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36201
Practice Address - Country:US
Practice Address - Phone:256-236-2271
Practice Address - Fax:256-236-1859
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11871183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist