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General NPI Number Information
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NPI Number | 1699896027
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Entity Type | Individual
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Provider Name | TRACEY LYNN KNOTT D.O.
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Gender | Female
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 5015 S ARIZONA MILLS CIR
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City | TEMPE
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State | AZ
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Zip | 85282-6401
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Country | US
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Telephone | 480-539-4000
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Fax | 480-539-7033
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Provider Business Mailing Address
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Address Line | 4530 E SHEA BLVD STE 180
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City | PHOENIX
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State | AZ
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Zip | 85028-6042
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Country | US
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Telephone | 602-264-4834
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Fax | 602-254-5178
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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 | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number | 036.124716
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207YX0007X
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Taxonomy Name | Plastic Surgery within the Head & Neck (Otolaryngology) Physician
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License Number | 006517
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License Number State | AZ
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