Provider Demographics
NPI:1174057624
Name:KNIGHT, CHAD MICHAEL (DPM)
Entity type:Individual
Prefix:MR
First Name:CHAD
Middle Name:MICHAEL
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 837
Mailing Address - Street 2:
Mailing Address - City:HOWE
Mailing Address - State:TX
Mailing Address - Zip Code:75459-0837
Mailing Address - Country:US
Mailing Address - Phone:903-487-2248
Mailing Address - Fax:903-487-2306
Practice Address - Street 1:3125 N SOONER RD STE 100
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-8333
Practice Address - Country:US
Practice Address - Phone:405-513-0385
Practice Address - Fax:405-888-8784
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-11
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OK344213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program