Provider Demographics
NPI:1174767545
Name:MCKNIGHT, JAMES ROBERT (RPH)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ROBERT
Last Name:MCKNIGHT
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 1:18 CHAMBERS DR
Mailing Address - Street 2:
Mailing Address - City:LANDER
Mailing Address - State:WY
Mailing Address - Zip Code:82520-9721
Mailing Address - Country:US
Mailing Address - Phone:307-332-5682
Mailing Address - Fax:
Practice Address - Street 1:18 CHAMBERS DR
Practice Address - Street 2:
Practice Address - City:LANDER
Practice Address - State:WY
Practice Address - Zip Code:82520-9721
Practice Address - Country:US
Practice Address - Phone:307-332-5682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-28
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY26251835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist