Individual
DR. BETHANY LANE KNIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
35 GRASSE STREET, CALICO ROCK, AR 72519
(870) 297-2475
(870) 297-4380
Mailing address
PO BOX 819, CALICO ROCK, AR 72519-0819
(870) 297-2475
(870) 297-4380
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
C8445
AR
208D00000X
General Practice Physician
C-8445
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04949
CIGNA
AR
05
—
129577001
—
AR
01
—
16627000000
QUALCHOICE
—
01
—
5K113
BLUE CROSS BLUE SHIELD
—
Enumeration date
02/28/2006
Last updated
04/03/2012
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