Basic Information
| Provider Information | |||||||||
| NPI: | 1265827133 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KNOX | ||||||||
| FirstName: | STEPHEN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 697 THOMAS LN | ||||||||
| Address2: | RIVERSIDE FAMILY PRACTICE | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432143931 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6145665414 | ||||||||
| FaxNumber: | 6145330433 | ||||||||
| Practice Location | |||||||||
| Address1: | 1210 ASHLAND AVE | ||||||||
| Address2: | |||||||||
| City: | ZANESVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 437012806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7404540370 | ||||||||
| FaxNumber: | 7404542411 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2015 | ||||||||
| LastUpdateDate: | 07/30/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 35.132282 | OH | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.