Healthcare Provider Details

I. General information

NPI: 1699875666
Provider Name (Legal Business Name): HECTOR EMILE KNOX JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 10/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8118 GOOD LUCK RD
LANHAM MD
20706-3595
US

IV. Provider business mailing address

2824 64TH AVE
CHEVERLY MD
20785-3118
US

V. Phone/Fax

Practice location:
  • Phone: 301-498-2922
  • Fax:
Mailing address:
  • Phone: 267-973-0122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD0064835
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: