Provider Demographics
NPI:1811161359
Name:ROBERT T KNIGHT MD PC
Entity type:Organization
Organization Name:ROBERT T KNIGHT MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:T
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-895-3993
Mailing Address - Street 1:1034 N HIGHLAND AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130
Mailing Address - Country:US
Mailing Address - Phone:615-895-3993
Mailing Address - Fax:615-895-3989
Practice Address - Street 1:1034 N HIGHLAND AVE
Practice Address - Street 2:SUITE A
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130
Practice Address - Country:US
Practice Address - Phone:615-895-3993
Practice Address - Fax:615-895-3989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD5968208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN338736Medicare Oscar/Certification
B04865Medicare UPIN