Healthcare Provider Details

I. General information

NPI: 1760642532
Provider Name (Legal Business Name): JAIME LAUREN KNIGHT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2008
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 JESSE HILL JR DR SE
ATLANTA GA
30303-3049
US

IV. Provider business mailing address

1321 DRUID OAKS NE
ATLANTA GA
30329-3274
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-1440
  • Fax:
Mailing address:
  • Phone: 404-748-4253
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number101249958
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: