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General NPI Number Information
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NPI Number | 1033222625
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Entity Type | Individual
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Provider Name | DAVID R KNOX MD
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Gender | Male
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 2512 HURST DR.
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City | MATTOON
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State | IL
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Zip | 61938-2500
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Country | US
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Telephone | 217-258-5900
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Fax | 217-258-5904
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Provider Business Mailing Address
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Address Line | 611 W. PARK ST. BWPC
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City | URBANA
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State | IL
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Zip | 61801-2500
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Country | US
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Telephone | 217-383-6792
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | 036100522
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 036100522
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License Number State | IL
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