Healthcare Provider Details

I. General information

NPI: 1184695504
Provider Name (Legal Business Name): MATTHEW CHRISTOPHER MCKNIGHT D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 4TH AVE
GRINNELL IA
50112-1898
US

IV. Provider business mailing address

202 4TH AVE
GRINNELL IA
50112-1898
US

V. Phone/Fax

Practice location:
  • Phone: 641-236-2008
  • Fax: 641-236-2031
Mailing address:
  • Phone: 641-236-2008
  • Fax: 641-236-2031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number00737
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: