Provider Demographics
NPI:1184822801
Name:KNOX, JENNIFER LYNN (DO)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LYNN
Last Name:KNOX
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:9338 OLIVE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63132-3248
Mailing Address - Country:US
Mailing Address - Phone:314-993-2400
Mailing Address - Fax:
Practice Address - Street 1:9338 OLIVE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63132-3248
Practice Address - Country:US
Practice Address - Phone:314-993-2400
Practice Address - Fax:314-993-5952
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2007016874207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine