Provider Demographics
NPI:1447202007
Name:KNIGHT, VINCENT K (MD)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:K
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5875 THOMPSON MILL RD.
Mailing Address - Street 2:STE. 200
Mailing Address - City:HOSCHTON
Mailing Address - State:GA
Mailing Address - Zip Code:30548
Mailing Address - Country:US
Mailing Address - Phone:770-965-2022
Mailing Address - Fax:770-967-6325
Practice Address - Street 1:601 S. ENOTA DRIVE
Practice Address - Street 2:STE. Q
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501
Practice Address - Country:US
Practice Address - Phone:770-533-8420
Practice Address - Fax:770-533-8440
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA054912207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA452274095EMedicaid
GA452274095HMedicaid
GA452274095EMedicaid
GA511I110656Medicare PIN
GA452274095HMedicaid