Provider Demographics
NPI:1972843803
Name:KNIGHT, CEDRIC O II (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:CEDRIC
Middle Name:O
Last Name:KNIGHT
Suffix:II
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5132 ROSEWOOD PL
Mailing Address - Street 2:
Mailing Address - City:FAIRBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30213-5117
Mailing Address - Country:US
Mailing Address - Phone:404-750-1786
Mailing Address - Fax:
Practice Address - Street 1:5132 ROSEWOOD PL
Practice Address - Street 2:
Practice Address - City:FAIRBURN
Practice Address - State:GA
Practice Address - Zip Code:30213-5117
Practice Address - Country:US
Practice Address - Phone:404-750-1786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-01
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH026791183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist