Healthcare Provider Details

I. General information

NPI: 1902871577
Provider Name (Legal Business Name): FLOYD E KNIGHT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 07/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 PHALEN BLVD MS 41103F
SAINT PAUL MN
55130-5302
US

IV. Provider business mailing address

401 PHALEN BLVD MS 41103F
SAINT PAUL MN
55130-5302
US

V. Phone/Fax

Practice location:
  • Phone: 651-254-7600
  • Fax: 651-254-7623
Mailing address:
  • Phone: 651-254-7600
  • Fax: 651-254-7623

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number24958
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number24319
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: