Healthcare Provider Details

I. General information

NPI: 1124222690
Provider Name (Legal Business Name): ROBERT D KNOX M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2007
Last Update Date: 01/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 OLD MAIN ST
HARTFORD KY
42347-1619
US

IV. Provider business mailing address

PO BOX 148
HARTFORD KY
42347-0148
US

V. Phone/Fax

Practice location:
  • Phone: 270-259-2714
  • Fax: 270-259-3593
Mailing address:
  • Phone: 270-259-2714
  • Fax: 270-259-3593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number26549
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: