Provider Demographics
NPI:1861446395
Name:KNIGHT, JOHN P (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 JACKSON PIKE
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-1560
Mailing Address - Country:US
Mailing Address - Phone:740-446-5137
Mailing Address - Fax:740-446-5749
Practice Address - Street 1:90 JACKSON PIKE
Practice Address - Street 2:
Practice Address - City:GALLIPOLIS
Practice Address - State:OH
Practice Address - Zip Code:45631-1560
Practice Address - Country:US
Practice Address - Phone:740-446-5137
Practice Address - Fax:740-446-5749
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-05-6770207Q00000X
WV15641207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0052258000Medicaid
OH0699810OtherMOLINA MEDICAID
OH000000181852OtherUNISON MEDICAID
080040486OtherRR MEDICARE
001714048OtherMOUNTAIN STATE BCBS
OH310917085109OtherCARESOURCE MEDICAID
OH0699810Medicaid
000000007503OtherANTHEM BCBS
WV0052258000Medicaid
OH0699810Medicaid
OH0627303Medicare PIN