Provider Demographics
NPI:1477241263
Name:KNIGHT, MASON JAMES (PA-C)
Entity Type:Individual
Prefix:
First Name:MASON
Middle Name:JAMES
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 HARDING RD
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-6540
Mailing Address - Country:US
Mailing Address - Phone:614-493-8996
Mailing Address - Fax:
Practice Address - Street 1:130 UNIVERSITY DR STE 1300
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-1118
Practice Address - Country:US
Practice Address - Phone:740-692-4440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-28
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.008084RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant