Provider Demographics
NPI:1861078438
Name:KNIGHTON, JOSHUA SHANE (MD)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:SHANE
Last Name:KNIGHTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4525 CAMERON VALLEY PKWY STE 4100D
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-4369
Mailing Address - Country:US
Mailing Address - Phone:980-402-1800
Mailing Address - Fax:980-402-1801
Practice Address - Street 1:4525 CAMERON VALLEY PKWY STE 4100D
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-4369
Practice Address - Country:US
Practice Address - Phone:980-402-1800
Practice Address - Fax:980-402-1801
Is Sole Proprietor?:No
Enumeration Date:2021-03-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2024-01192207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine