Healthcare Provider Details

I. General information

NPI: 1679079362
Provider Name (Legal Business Name): ALYSSA N KNIGHT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2018
Last Update Date: 05/22/2024
Certification Date: 05/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 19TH ST SOUTH JT N382
BIRMINGHAM AL
35294-2300
US

IV. Provider business mailing address

2451 USA MEDICAL CENTER DR
MOBILE AL
36617-2300
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-3175
  • Fax:
Mailing address:
  • Phone: 251-471-7207
  • Fax: 251-471-7468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD.43418
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberMD.43418
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: