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General NPI Number Information
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NPI Number | 1780844431
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Entity Type | Individual
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Provider Name | JESSE KNIGHT MD
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Gender | Male
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Dates
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Enumeration Date | 06/16/2008
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Last Update Date | 07/13/2020
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Provider Practice Location Address
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Address Line | 2376 N 400 E STE 202
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City | TOOELE
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State | UT
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Zip | 84074-3413
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Country | US
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Telephone | 435-833-9600
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Fax | 435-882-4743
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Provider Business Mailing Address
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Address Line | 2561 S 1560 W UNIT B
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City | WOODS CROSS
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State | UT
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Zip | 84087-2361
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Country | US
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Telephone | 801-505-0821
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 11810844-1205
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License Number State | UT
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