# RICHARD W. KING JR, MD

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** RICHARD W. KING JR, MD
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1154640209
- **Legal business name:** RICHARD W. KING JR, MD
- **Authorized official:** ELIZABETH R LEWIS (REIMBURSEMENT DIRECTOR)
- **Authorized official phone:** (678) 303-3200

## Contact information

- **Practice address:** 500 MEDICAL CENTER BLVD, SUITE 170, LAWRENCEVILLE, GA 30046-8708
- **Practice address phone:** (678) 303-3200
- **Practice address fax:** (678) 303-3205
- **Mailing address:** 2550 WINDY HILL RD SE, SUITE 110, MARIETTA, GA 30067-8665
- **Mailing address phone:** (678) 303-3200
- **Mailing address fax:** (678) 303-3205

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225400000X | Rehabilitation Practitioner | 021872 | GA | Yes |

## Other

- **Enumeration date:** 05/27/2010
- **Last updated:** 05/27/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00875201A | — | GA |