Provider Demographics
NPI:1487632899
Name:KNIGHT, DOUGLAS GRAHAM (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:GRAHAM
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1550 HIGHWAY 71 NE
Mailing Address - Street 2:
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-9504
Mailing Address - Country:US
Mailing Address - Phone:320-231-5100
Mailing Address - Fax:320-231-5329
Practice Address - Street 1:1550 HIGHWAY 71 NE
Practice Address - Street 2:
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-9504
Practice Address - Country:US
Practice Address - Phone:320-231-5100
Practice Address - Fax:320-231-5329
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN22029207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN2D886KNOtherBC/BS MPIN
MN2D886KNOtherBC/BS MPIN