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NPI Code Detail

MEDICARE: JOHN KNOX MD

MEDICARE: JOHN KNOX MD
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
1208000000XPediatrics Physician022575GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
140469OTHERGREAT WEST
2691303OTHERCIGNA HEALTHCARE
34294479OTHERAETNA CAPITATED
4550627OTHERAETNA
5149030OTHERBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1750346961
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN KNOX MD
Provider Business Mailing Address
First Line : 1100 LAKE HEARN DR NE
Second Line : SUITE 100
City : ATLANTA
State : GA
Zip : 30342-1523
Country : US
Telephone Number : 404-256-3178
Fax Number : 404-256-3583
Provider Business Practice Location Address
First Line : 1100 LAKE HEARN DR NE
Second Line : SUITE 100
City : ATLANTA
State : GA
Zip : 30342-1523
Country : US
Telephone Number : 404-256-3178
Fax Number : 404-256-3583
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2006
Last Update Date : 07/08/2007

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Directions to “ JOHN KNOX MD” Practice Location

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