Provider Demographics
NPI:1275518508
Name:KNIGHT, GREGORY A (PA-C)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:A
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1726 MEDICAL BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1426
Mailing Address - Country:US
Mailing Address - Phone:239-598-1250
Mailing Address - Fax:239-598-2745
Practice Address - Street 1:1726 MEDICAL BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1426
Practice Address - Country:US
Practice Address - Phone:239-598-1250
Practice Address - Fax:239-598-2745
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2015-03-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA2475363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL290379200Medicaid
U51999Medicare UPIN
FLE0426YMedicare ID - Type Unspecified