MEDICARE: THOMAS E. MCKNIGHT JR DO MPH INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	20A4876	CA
2	204D00000X	Neuromusculoskeletal Medicine & OMM Physician	20A4876	CA
3	2084N0400X	Neurology Physician	20A4876	CA
4	2084N0600X	Clinical Neurophysiology Physician	20A4876	CA
5	2084S0012X	Sleep Medicine (Psychiatry & Neurology) Physician	20A4876	CA
6	2083P0901X	Public Health & General Preventive Medicine Physician	20A4876	CA
7	208D00000X	General Practice Physician	20A4876	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DO9225	OTHER	CA	MEDICARE RAILROAD #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124169388
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS E. MCKNIGHT JR DO MPH INC

Provider Business Mailing Address
First Line	:	236 W EAST AVE
Second Line	:	PMB 104
City	:	CHICO
State	:	CA
Zip	:	95926-7235
Country	:	US
Telephone Number	:	530-896-0260
Fax Number	:	530-896-0287

Provider Business Practice Location Address
First Line	:	130 INDEPENDENCE CIR
Second Line	:	SUITE 5
City	:	CHICO
State	:	CA
Zip	:	95973-4962
Country	:	US
Telephone Number	:	530-896-0260
Fax Number	:	530-896-0287

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. THOMAS E MCKNIGHT JR.
Credential	:	DO MPH
Telephone Number	:	530-896-0260

Provider Enumeration Date	:	02/09/2007
Last Update Date	:	02/22/2024

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