Provider Demographics
NPI:1396962775
Name:NORRIS KNIGHT MD ORTHOPEDICS
Entity type:Organization
Organization Name:NORRIS KNIGHT MD ORTHOPEDICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NORRIS
Authorized Official - Middle Name:C
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-794-4325
Mailing Address - Street 1:PO BOX 988
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75504-0988
Mailing Address - Country:US
Mailing Address - Phone:903-793-7994
Mailing Address - Fax:
Practice Address - Street 1:1002 TEXAS BLVD
Practice Address - Street 2:STE 407
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75501-5107
Practice Address - Country:US
Practice Address - Phone:903-794-4325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD2252207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5578930001Medicare NSC