Provider Demographics
NPI:1174563274
Name:MCKNIGHT EYE CENTERS, PC
Entity type:Organization
Organization Name:MCKNIGHT EYE CENTERS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCKNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-781-2900
Mailing Address - Street 1:515 N STATE ROUTE 291
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-1045
Mailing Address - Country:US
Mailing Address - Phone:816-781-2900
Mailing Address - Fax:816-781-1370
Practice Address - Street 1:515 N STATE ROUTE 291
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-1045
Practice Address - Country:US
Practice Address - Phone:816-781-2900
Practice Address - Fax:816-781-1370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOT03336152W00000X
332H00000X
MOMDR5G65207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No332H00000XSuppliersEyewear SupplierGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO504770504Medicaid
MO504770504Medicaid
MO5422780001Medicare NSC