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Individual
DR. GRAYDEN WOODRUFF KING
Active
Individual
DR. GRAYDEN WOODRUFF KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
DP 00436
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
377694001
—
TX
05
—
377694002
—
TX
01
—
R141926
MEDICARE PTAN
OR
Enumeration date
09/18/2007
Last updated
12/28/2017
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