Provider Demographics
NPI:1679578538
Name:MCKNIGHT, THOMAS E JR (DO MPH)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:E
Last Name:MCKNIGHT
Suffix:JR
Gender:M
Credentials:DO MPH
Other - Prefix:
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Mailing Address - Street 1:236 W EAST AVE
Mailing Address - Street 2:PMB 104
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-7235
Mailing Address - Country:US
Mailing Address - Phone:530-896-0260
Mailing Address - Fax:530-896-0287
Practice Address - Street 1:130 INDEPENDENCE CIR
Practice Address - Street 2:SUITE 5
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-4962
Practice Address - Country:US
Practice Address - Phone:530-896-0260
Practice Address - Fax:530-896-0287
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A48762084N0400X, 207R00000X, 2084N0008X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular Medicine
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX48760Medicaid
130026036OtherMEDICARE RAILROAD #
CA00AX48760Medicaid
CA020A48760Medicare PIN