Provider Demographics
NPI:1861969776
Name:KNIGHT, TIMOTHY ALBERT I
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:ALBERT
Last Name:KNIGHT
Suffix:I
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 1:1513 ROCKPORT RD
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-7947
Mailing Address - Country:US
Mailing Address - Phone:903-267-9848
Mailing Address - Fax:
Practice Address - Street 1:717 HIGHWAY 70 E
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:OK
Practice Address - Zip Code:73439-8253
Practice Address - Country:US
Practice Address - Phone:903-267-9848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-29
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management