Provider Demographics
NPI:1922022664
Name:MCKNIGHT, GARY L (AUD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:L
Last Name:MCKNIGHT
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 SW CORPORATE VW
Mailing Address - Street 2:SUITE 220
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66615-1244
Mailing Address - Country:US
Mailing Address - Phone:785-228-6100
Mailing Address - Fax:785-228-6101
Practice Address - Street 1:601 SW CORPORATE VW
Practice Address - Street 2:SUITE 220
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66615-1244
Practice Address - Country:US
Practice Address - Phone:785-228-6100
Practice Address - Fax:785-228-6101
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01544231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS115408OtherBLUE CROSS BLUE SHIELD
KS100346200BMedicaid
KS115408Medicare ID - Type Unspecified