MEDICARE: LARA MCKNIGHT, OD & ASSOC LTD

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	152W00000X	Optometrist	481	NV

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	:	1245576768
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LARA MCKNIGHT, OD & ASSOC LTD

Provider Business Mailing Address
First Line	:	16012 GREEN SPRINGS DR
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89511-8138
Country	:	US
Telephone Number	:	775-722-0271
Fax Number	:

Provider Business Practice Location Address
First Line	:	4530 S CARSON ST STE 12
Second Line	:
City	:	CARSON CITY
State	:	NV
Zip	:	89701-6914
Country	:	US
Telephone Number	:	775-267-2000
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LARA MCKNIGHT
Credential	:	O.D.
Telephone Number	:	775-722-0271

Provider Enumeration Date	:	01/02/2013
Last Update Date	:	12/09/2016

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