Provider Demographics
NPI:1700245388
Name:KNOX, ALECIA N (PA-C)
Entity Type:Individual
Prefix:MS
First Name:ALECIA
Middle Name:N
Last Name:KNOX
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 CORPORATE PL
Mailing Address - Street 2:
Mailing Address - City:ALCOA
Mailing Address - State:TN
Mailing Address - Zip Code:37701-1940
Mailing Address - Country:US
Mailing Address - Phone:865-331-9050
Mailing Address - Fax:865-374-2008
Practice Address - Street 1:205 CORPORATE PL
Practice Address - Street 2:
Practice Address - City:ALCOA
Practice Address - State:TN
Practice Address - Zip Code:37701-1940
Practice Address - Country:US
Practice Address - Phone:865-331-9050
Practice Address - Fax:865-374-2008
Is Sole Proprietor?:No
Enumeration Date:2016-02-11
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3943363A00000X
MTMED-PAC-LIC-44727363AS0400X
TN3943T363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ052186Medicaid