Healthcare Provider Details

I. General information

NPI: 1942421391
Provider Name (Legal Business Name): DAVID F. KNIGHT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 02/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 E 5TH ST DEPT OF RADIOLOGY
WASHINGTON MO
63090-3127
US

IV. Provider business mailing address

11475 OLDE CABIN RD SUITE 200
SAINT LOUIS MO
63141-7128
US

V. Phone/Fax

Practice location:
  • Phone: 636-239-8250
  • Fax: 636-239-8271
Mailing address:
  • Phone: 314-991-8200
  • Fax: 314-569-1787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number2009007658
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number24161
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: