CHARLES D KNIGHT JR. (NPI# 1912901794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912901794 |
| Entity Type | Individual |
| Full Name | CHARLES D KNIGHT JR. |
| Credential | MD |
| Practice Address |
1455 E Bert Kouns Industrial Loop Ste 202 Shreveport LA 71105-5634 |
| Mailing Address |
1455 E Bert Kouns Industrial Loop Shreveport LA 71105-6000 |
| Practice Telephone | 3187984691 |
| Practice Fax Number | 3187984412 |
| Mailing Telephone | 3187984691 |
| Mailing Fax Number | 3187984412 |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2019-12-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
06896R | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | GROUP NPI NUMBER | 1053315846 | 01 |
| LA | RAILROAD MEDICARE NUMBER | 020021594 | 01 |
| TX | TEXAS MEDICAID NUMBER | 153013101 | 01 |
| LA | 1376426 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376948349 | Charles Douglas Knight | Military Health Care Provider | Uss Maryland Ssbn 738, Fpo, AA 23703 | 2014-11-03 |
| 1104935782 | Charles Ed Knight | Dentist | 9601 Lile Dr Ste 240, Little Rock, AR 72205-6342 | 2006-08-29 |
| 1346247012 | Charles Duane Knight | Chiropractor | 79440 Corporate Center Dr, Suite 108, La Quinta, CA 92253-7241 | 2005-07-07 |
| 1114540523 | Charles R Knight | Pharmacist | 3005 Lake St, Omaha, NE 68111-3780 | 2020-05-19 |
| 1427303288 | Charles Anthony Knight | Military Health Care Provider | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2012-07-18 |
| 1194869388 | Charles Bg Knight | Radiology | 2314 Nw Kings Blvd # A, Corvallis, OR 97330-3925 | 2007-02-19 |
| 1306805064 | Charles W Knight | Internal Medicine | 1397 S Loop Rd, Pahrump, NV 89048-4729 | 2006-03-21 |
| 1184619926 | Charles W Knight Jr. | Internal Medicine | 8333 N Davis Hwy, Pensacola, FL 32514-6050 | 2005-09-19 |
| Street Address |
1455 E BERT KOUNS INDUSTRIAL LOOP STE 202 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71105-5634 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699245928 | Misty Johnetta Ross | Counselor | 2942 Knight St., Bldg. 4 Suite 426, Shreveport, LA 71105 | 2018-11-29 |
| 1205301868 | Tatjhana Maury | Case Manager/Care Coordinator | 3325 Youree Drive, Shreveport, LA 71105 | 2018-10-10 |
| 1245710920 | Jefferey Douglas Adair Md | Non-Pharmacy Dispensing Site | 8860 Fern Ave., Suite 120, Shreveport, LA 71105 | 2018-08-21 |
| 1679059539 | Michael E Woolbert Dds LLC | Dentist | 7600 Fern Avenue, Building 1100, Shreveport, LA 71105 | 2018-07-13 |
| 1881195675 | Adiba Bibi | Pharmacist | 3555 Greenwood Road, Walgreens, Shreveport, LA 71105 | 2018-02-27 |
| 1740796655 | Allison Borel | Counselor | 2020 E 70th St Ste 201, Shreveport, LA 71105 | 2017-12-15 |
| 1073028148 | Valerie Wooten Barcelona | Physical Therapist | 130 Kayla Street, Shreveport, LA 71105 | 2017-12-11 |
| 1710497615 | Jimmy Carroll | Counselor | 2960 Knight St, Suite 110, Shreveport, LA 71105 | 2017-10-05 |
| 1932618444 | David Louis Bennett | Counselor | 3007 Knight St., Suite 200, Shreveport, LA 71105 | 2017-09-27 |
| 1619496452 | Shaqwana Hodge | Counselor | 2920 Knight St. Suite 110, Shreveport, LA 71105 | 2017-09-13 |
| Find all providers in zip 71105 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598001687 | Rodric Marsh Yeager | Surgery | 7717 Creswell Rd, 46, Shreveport, LA 71106-6000 | 2012-12-18 |
| 1164435475 | Stephen Collier White | Surgery | 1455 E Bert Kouns, Highland Clinic, Apmc, Shreveport, LA 71105 | 2006-08-15 |
| 1396785945 | Milton Slocum | Surgery | 3300 Albert L Bicknell Dr Ste 3d, Shreveport, LA 71103-3903 | 2006-06-08 |
| 1245522564 | Miles A Sugar II | Surgery | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2011-05-04 |
| 1598096240 | Wk Vascular Surgical Associates | Surgery | 2751 Albert L Bicknell Dr, Suite 5a, Shreveport, LA 71103-3920 | 2010-01-20 |
| 1285897132 | Chiranjiv Singh Virk | Surgery | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2008-07-09 |
| 1851433478 | William L. Eddleman, Md, Apmc | Surgery | 2751 Albert L Bicknell Dr, Suite 1a, Shreveport, LA 71103-3920 | 2007-02-12 |
| 1538209697 | Fredrick Willius Knight | Surgery | 2751 Albert L Bicknell Dr, Suite 5-a, Shreveport, LA 71103-3920 | 2007-02-07 |
| 1669413787 | Robert L Barrett | Surgery | 8001 Youree Dr, Shreveport, LA 71115-2302 | 2006-06-09 |
| 1275572265 | William Loy Eddleman | Surgery | 2751 Albert L Bicknell Dr, Suite 1a, Shreveport, LA 71103-3920 | 2006-06-05 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71105 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.