Provider Demographics
NPI:1639151764
Name:KNIGHT, STEPHEN H (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:H
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1459 MONTREAL RD
Mailing Address - Street 2:STE 501
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-6900
Mailing Address - Country:US
Mailing Address - Phone:770-491-3700
Mailing Address - Fax:770-491-7581
Practice Address - Street 1:1459 MONTREAL RD
Practice Address - Street 2:STE 501
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-6900
Practice Address - Country:US
Practice Address - Phone:770-491-3700
Practice Address - Fax:770-491-7581
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-15
Last Update Date:2008-04-20
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Provider Licenses
StateLicense IDTaxonomies
GA028586207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00335222BMedicaid
GA00335222BMedicaid
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