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1972617744

NPI Code Detail

MEDICARE: HAVON KNIGHT MD

MEDICARE: HAVON 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	207R00000X	Internal Medicine Physician	C160487	CA
2	207R00000X	Internal Medicine Physician	036.151442	IL
3	207R00000X	Internal Medicine Physician	MD23630	ME
4	207R00000X	Internal Medicine Physician	MD.43824	AL
5	207R00000X	Internal Medicine Physician	15597	MS
6	207R00000X	Internal Medicine Physician	041448	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1559117	OTHER	MS	AMERICAN ADMIN GROUP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	041448	OTHER	GA	GA MEDICAL LICENSE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972617744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAVON KNIGHT MD

Provider Business Mailing Address
First Line	:	102 WOODMONT BLVD STE 600
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37205-5250
Country	:	US
Telephone Number	:	615-314-5257
Fax Number	:	615-692-0547

Provider Business Practice Location Address
First Line	:	5740 N GRAHAM ST
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-4839
Country	:	US
Telephone Number	:	704-251-8340
Fax Number	:	980-549-3832

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

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	05/08/2024

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Directions to “ HAVON KNIGHT MD” Practice Location

Language	Start Address	Practice Location

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