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Individual

ELLIS M. KNIGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1007 N POPE ST, SILVER CITY, NM 88061-5161
(575) 388-1511
(575) 313-8236
Mailing address
530 DE MOSS ST, LORDSBURG, NM 88045-2618
(575) 542-8384
(803) 296-7330

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
80976
GA
207R00000X
Internal Medicine Physician
Primary
MD2022-0306
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
80976
GA BOARD OF MEDICAL EXAMINERS
GA
Enumeration date
06/10/2006
Last updated
04/29/2022
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