Provider Demographics
NPI:1376543967
Name:KNIGHT, EMERSON LEROY JR (MD)
Entity Type:Individual
Prefix:MR
First Name:EMERSON
Middle Name:LEROY
Last Name:KNIGHT
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:304 N PAXTANG AVE
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-1842
Mailing Address - Country:US
Mailing Address - Phone:717-982-8420
Mailing Address - Fax:717-564-6212
Practice Address - Street 1:304 N PAXTANG AVE
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-1842
Practice Address - Country:US
Practice Address - Phone:717-982-8420
Practice Address - Fax:717-564-6212
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-26
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-015366-E208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F46257Medicare UPIN
PA071165Medicare PIN
F46257Medicare UPIN
PA153053Medicare ID - Type Unspecified