Provider Demographics
NPI:1487437117
Name:KNIGHT, PHILLIP BARTLEY
Entity type:Individual
Prefix:
First Name:PHILLIP
Middle Name:BARTLEY
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 CHURCH ST APT 308
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2599
Mailing Address - Country:US
Mailing Address - Phone:865-964-7810
Mailing Address - Fax:
Practice Address - Street 1:8110 HIGHWAY 100
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:TN
Practice Address - Zip Code:37221-4214
Practice Address - Country:US
Practice Address - Phone:615-673-1251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000047223183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist