Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | DO1010 | AL |
Y | 207VX0000X | Obstetrician | 2250 | TN |
NPI | 1346441706 |
---|---|
Provider Name | Dr. Jason R Knott |
First Address | Batesville, AR 72501-7203 |
Second Address | Batesville, AR 72501-7203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2007 |
Last Update Date | 28/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103I160651 | MEDICARE PTAN (01) | TN |