Provider Demographics
NPI:1538503503
Name:KNOX CLINIC CORP
Entity Type:Organization
Organization Name:KNOX CLINIC CORP
Other - Org Name:MEDICAL ARTS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SOPHIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ARWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-628-6038
Mailing Address - Street 1:PO BOX 689022
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37068-9022
Mailing Address - Country:US
Mailing Address - Phone:615-628-6038
Mailing Address - Fax:605-465-3007
Practice Address - Street 1:834 N SEMINARY ST
Practice Address - Street 2:SUITE 201
Practice Address - City:GALESBURG
Practice Address - State:IL
Practice Address - Zip Code:61401-2852
Practice Address - Country:US
Practice Address - Phone:309-343-7035
Practice Address - Fax:309-343-7212
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KNOX CLINIC CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-04-22
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health