Provider Demographics
NPI:1841294618
Name:KNIGHT, ERIC L (OD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:L
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1950 OLD GALLOWS RD STE 520
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3970
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:7300 W GREENFIELD AVE
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53214-4729
Practice Address - Country:US
Practice Address - Phone:414-453-6667
Practice Address - Fax:414-774-5505
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2138-035152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38529800Medicaid
WI38529800Medicaid
WI000147720Medicare PIN
WIT62444Medicare UPIN