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Individual

CHARLES BG KNIGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2314 NW KINGS BLVD # A, CORVALLIS, OR 97330-3925
(541) 758-5047
(541) 758-3713
Mailing address
PO BOX 1418, CORVALLIS, OR 97339-1418
(541) 758-5047
(541) 758-3713

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD27407
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
274236
OR
Enumeration date
02/19/2007
Last updated
11/09/2007
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