Individual
JERRY MCKNIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
850 PETER BRYCE BLVD, TUSCALOOSA, AL 35401-7419
(205) 348-1770
(205) 348-6561
Mailing address
9174 PARKWAY E, BIRMINGHAM, AL 35206-1507
(205) 498-2675
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10970
AL
207QG0300X
Geriatric Medicine (Family Medicine) Physician
10970
AL
207R00000X
Internal Medicine Physician
10970
AL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
10970
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000011765
—
AL
Enumeration date
01/25/2006
Last updated
03/07/2023
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