Provider Demographics
NPI:1700820610
Name:KNOX, THOMAS J (MD,MBA,DABIPP,FIPP)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:J
Last Name:KNOX
Suffix:
Gender:M
Credentials:MD,MBA,DABIPP,FIPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7671 TYLERS PLACE BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-6331
Mailing Address - Country:US
Mailing Address - Phone:513-432-4645
Mailing Address - Fax:513-779-6900
Practice Address - Street 1:7671 TYLERS PLACE BLVD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-6331
Practice Address - Country:US
Practice Address - Phone:513-432-4645
Practice Address - Fax:513-779-6900
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35050928K207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0572670Medicaid
OH2020091OtherUNITED HEALTHCARE
OH050013907OtherRAILROAD MEDICARE
OH000000015761OtherANTHEM
C03350Medicare UPIN
OH050013907OtherRAILROAD MEDICARE
OH2020091OtherUNITED HEALTHCARE