=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801455712
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOSE ENRIQUE KNOX MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/13/2019
-----------------------------------------------------
Last Update Date | 02/14/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 36018 NORTH SECRET GARDEN PATH
-----------------------------------------------------
City | QUEEN CREEK
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85140
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-842-1983
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4144 E BLAZER RD
-----------------------------------------------------
City | SAN TAN VALLEY
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85140-1675
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-714-1639
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 78038
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------