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General NPI Number Information
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NPI Number | 1154401859
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Entity Type | Individual
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Provider Name | JONATHAN JULIAN KNIGHT PHARMD
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Gender | Male
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 12/19/2012
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Provider Practice Location Address
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Address Line | 2 E WILLIAM WAINWRIGHT ST
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City | REYNOLDS
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State | GA
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Zip | 31076-3150
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Country | US
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Telephone | 478-847-3666
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Fax | 478-847-2666
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Provider Business Mailing Address
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Address Line | 2 E WILLIAM WAINWRIGHT ST
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City | REYNOLDS
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State | GA
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Zip | 31076-3150
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Country | US
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Telephone | 478-847-3666
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Fax | 478-847-2666
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 020486
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License Number State | GA
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