Provider Demographics
NPI:1336157064
Name:MCKNIGHT, DENISE A (MD)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:A
Last Name:MCKNIGHT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:A
Other - Last Name:ELLIOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3510 N CAUSEWAY BLVD
Mailing Address - Street 2:SUITE 404
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-3531
Mailing Address - Country:US
Mailing Address - Phone:504-779-5515
Mailing Address - Fax:
Practice Address - Street 1:309 JACKSON ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-7407
Practice Address - Country:US
Practice Address - Phone:504-779-5515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.09584R207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1961680Medicaid
LAF52384Medicare UPIN
LA1961680Medicaid