Provider Demographics
NPI:1164633640
Name:JONES-MCKNIGHT, TABITHA ISABEL (DO)
Entity Type:Individual
Prefix:DR
First Name:TABITHA
Middle Name:ISABEL
Last Name:JONES-MCKNIGHT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:TABITHA
Other - Middle Name:ISABEL
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:700 CHILDRENS DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2664
Mailing Address - Country:US
Mailing Address - Phone:614-722-4579
Mailing Address - Fax:614-722-4565
Practice Address - Street 1:700 CHILDRENS DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2664
Practice Address - Country:US
Practice Address - Phone:614-722-4579
Practice Address - Fax:614-722-4565
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.009358208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0092481Medicaid