Provider Demographics
NPI:1750346961
Name:KNOX, JOHN (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:KNOX
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1100 LAKE HEARN DR NE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1523
Mailing Address - Country:US
Mailing Address - Phone:404-256-3178
Mailing Address - Fax:404-256-3583
Practice Address - Street 1:1100 LAKE HEARN DR NE
Practice Address - Street 2:SUITE 100
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1523
Practice Address - Country:US
Practice Address - Phone:404-256-3178
Practice Address - Fax:404-256-3583
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA022575208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
40469OtherGREAT WEST
691303OtherCIGNA HEALTHCARE
4294479OtherAETNA CAPITATED
550627OtherAETNA
149030OtherBLUE CROSS BLUE SHIELD
691303OtherCIGNA HEALTHCARE