Provider Demographics
NPI:1982945143
Name:KNIGHT, MIKE II
Entity Type:Individual
Prefix:
First Name:MIKE
Middle Name:
Last Name:KNIGHT
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12600 N MACARTHUR BLVD
Mailing Address - Street 2:1009
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73142-2939
Mailing Address - Country:US
Mailing Address - Phone:405-535-0378
Mailing Address - Fax:
Practice Address - Street 1:12600 N MACARTHUR BLVD
Practice Address - Street 2:1009
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73142-2939
Practice Address - Country:US
Practice Address - Phone:405-535-0378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health