Basic Information
| Provider Information | |||||||||
| NPI: | 1942258512 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KNIGHT | ||||||||
| FirstName: | PAMELA | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8101 EAST LOWRY BOULEVARD | ||||||||
| Address2: | SUITE 260 | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802307197 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3032144500 | ||||||||
| FaxNumber: | 3032144571 | ||||||||
| Practice Location | |||||||||
| Address1: | 8101 EAST LOWRY BOULEVARD | ||||||||
| Address2: | SUITE 260 | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802307197 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3032144500 | ||||||||
| FaxNumber: | 3032144571 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2006 | ||||||||
| LastUpdateDate: | 02/03/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 34192 | CO | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
ID Information
| ID | Type | State | Issuer | Description | 01341924 | 05 | CO | MEDICAID |