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NPI Code Detail

MEDICARE: JONATHAN M. KNOX D.O.

MEDICARE: JONATHAN M. KNOX D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician3130OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
120695OTHEROKOBNDD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3080141683OTHEROKRAILROAD
43130OTHEROKLICENSE

General Provider Information

NPI Number : 1801823505
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN M. KNOX D.O.
Provider Business Mailing Address
First Line : 4401 W MEMORIAL RD
Second Line : SUITE 140
City : OKLAHOMA CITY
State : OK
Zip : 73134-1785
Country : US
Telephone Number : 405-752-3162
Fax Number : 405-936-5211
Provider Business Practice Location Address
First Line : 5201 W MEMORIAL RD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73142-2004
Country : US
Telephone Number : 405-755-4050
Fax Number : 405-749-9566
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2006
Last Update Date : 05/20/2014

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