Provider Demographics
NPI:1518998053
Name:KNOX, JAMI ADAIR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMI
Middle Name:ADAIR
Last Name:KNOX
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JAMI
Other - Middle Name:ADAIR
Other - Last Name:WICHERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8512 HIGHWAY 39
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97603-9712
Mailing Address - Country:US
Mailing Address - Phone:808-652-5692
Mailing Address - Fax:
Practice Address - Street 1:601 JOHN ST STE E-352
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5341
Practice Address - Country:US
Practice Address - Phone:269-341-8986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-15136208000000X
ORMD198805208000000X
MI4301070653208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00C028443OtherHMSA
36-4505589OtherAETNA
HI10738Medicaid
MI4441175Medicaid
35-03306222OtherBLUE CROSS/BLUE SHIELD
36-4505589OtherAETNA