Provider Demographics
NPI:1497081319
Name:KNIGHT, STEPHEN PATRICK (RPA, RT(R))
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:PATRICK
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:RPA, RT(R)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 CREEK POINT BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-8307
Mailing Address - Country:US
Mailing Address - Phone:904-487-2356
Mailing Address - Fax:
Practice Address - Street 1:655 WEST EIGHTH STREET C90
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209
Practice Address - Country:US
Practice Address - Phone:904-244-6086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-28
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
07 TX 1287243U00000X
FL54399247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes243U00000XTechnologists, Technicians & Other Technical Service ProvidersRadiology Practitioner Assistant
No247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist