Provider Demographics
NPI:1548227994
Name:KNOTT, PATRICIA ANN (MD)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANN
Last Name:KNOTT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:PATRICIA
Other - Middle Name:ATKINS
Other - Last Name:KNOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:809 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032-5809
Mailing Address - Country:US
Mailing Address - Phone:501-336-9999
Mailing Address - Fax:501-336-9995
Practice Address - Street 1:809 4TH AVE
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-5809
Practice Address - Country:US
Practice Address - Phone:501-336-9999
Practice Address - Fax:501-336-9995
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA019565208100000X
ARR4218208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARDC4317OtherRAILROAD MEDICARE
ARDC4317OtherRAILROAD MEDICARE
AR54548Medicare PIN