1609070283 NPI number — DR. TECHKSELL MCKNIGHT WASHINGTON MD, MPH

Table of content: DR. TECHKSELL MCKNIGHT WASHINGTON MD, MPH (NPI 1609070283)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609070283 NPI number — DR. TECHKSELL MCKNIGHT WASHINGTON MD, MPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WASHINGTON
Provider First Name:
TECHKSELL
Provider Middle Name:
MCKNIGHT
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD, MPH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MCKNIGHT
Provider Other First Name:
TECHKSELL
Provider Other Middle Name:
MESHELL
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD, MPH
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1609070283
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/29/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
301 UNIVERSITY BLVD
Provider Second Line Business Mailing Address:
DEPARTMENT OF INTERNAL MEDICINE, DIVISION OF HEM/ONC
Provider Business Mailing Address City Name:
GALVESTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77555-5302
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2809 DENNY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PASCAGOULA
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39581-5301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
228-809-5251
Provider Business Practice Location Address Fax Number:
228-809-5255
Provider Enumeration Date:
06/14/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  N2190 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2083P0901X , with the licence number: BP2-0025832 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RX0202X , with the licence number: 26149 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2775812560 . This is a "MYUTMB 2775812560-COMMERCIAL NUMBER" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com