Provider Demographics
NPI:1689699787
Name:KNIGHT, DAWN C (MD)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:C
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 SUNSET
Mailing Address - Street 2:
Mailing Address - City:LA GRANDE
Mailing Address - State:OR
Mailing Address - Zip Code:97850
Mailing Address - Country:US
Mailing Address - Phone:541-663-3175
Mailing Address - Fax:318-387-7919
Practice Address - Street 1:610 SUNSET
Practice Address - Street 2:
Practice Address - City:LA GRANDE
Practice Address - State:OR
Practice Address - Zip Code:97850
Practice Address - Country:US
Practice Address - Phone:541-663-3175
Practice Address - Fax:318-387-7919
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD017839207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA39156OtherBLUE CROSS BLUE SHIELD
LA1352721Medicaid
LA39156OtherBLUE CROSS BLUE SHIELD
LA1352721Medicaid