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General NPI Number Information
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NPI Number | 1699193540
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Entity Type | Organization
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Legal Business Name | DANIEL R. KNIGHT, MD, LLC
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Dates
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Enumeration Date | 03/28/2014
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Last Update Date | 03/28/2014
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Provider Practice Location Address
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Address Line | 7607 FERN AVE #502
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City | SHREVEPORT
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State | LA
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Zip | 71105-5739
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Country | US
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Telephone | 318-798-4595
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 53316
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City | SHREVEPORT
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State | LA
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Zip | 71135-3316
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Country | US
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Telephone | 318-798-4595
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Fax |
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Authorized Official
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Title or Position | MD/OWNER
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Name | DR. DANIEL ROBERT KNIGHT
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Credential | MD
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Telephone | 318-798-4595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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