MEDICARE: DR. MELVIN JAY KNIGHT 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
1	207Q00000X	Family Medicine Physician	3641	NV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	CC171Z	OTHER	NV	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1427283860	OTHER	NV	CLINIC TAX NPI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	94-1196203	OTHER	NV	CLINIC TAX ID
5	CC163A	OTHER	NV	CLINIC PTAN

General Provider Information

NPI Number	:	1861472979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELVIN JAY KNIGHT MD

Provider Business Mailing Address
First Line	:	5295 SUN VALLEY BLVD
Second Line	:
City	:	SUN VALLEY
State	:	NV
Zip	:	89433-7954
Country	:	US
Telephone Number	:	775-674-5430
Fax Number	:	775-674-5440

Provider Business Practice Location Address
First Line	:	5295 SUN VALLEY BLVD
Second Line	:
City	:	SUN VALLEY
State	:	NV
Zip	:	89433-7954
Country	:	US
Telephone Number	:	775-674-5430
Fax Number	:	775-674-5440

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/17/2006
Last Update Date	:	10/19/2009

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