Knight-Mathis, Vicki D

Knight-Mathis, Vicki D is an individual health care provider with primary practice located at 2920 Marietta Hwy Suite 142, Canton GA 30114-8212. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Knight-Mathis, Vicki D can be contacted via phone (770) 704-0057.

Contact Information

Primary practice address
2920 Marietta Hwy Suite 142 Canton GA 30114-8212
Phone: (770) 704-0057
Fax: (770) 704-0223
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 47337 Georgia

Profile Details

NPI number 1013916212
LBN Legal business name Knight-Mathis, Vicki D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2005
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013916212 NPPES
Georgia MEDICAID 00824788B

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