Organization
MALCOLM H. KING, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MALCOLM H. KING M.D. (PRESIDENT)
(606) 325-9633
Entity
Organization
Contact information
Practice address
2301 LEXINGTON AVE, SUITE 205, ASHLAND, KY 41101-2873
(606) 325-9633
(606) 325-9634
Mailing address
2301 LEXINGTON AVE, SUITE 205, ASHLAND, KY 41101-2833
(606) 325-9633
(606) 325-9634
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
12569
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000045301
ANTHEM/BLUE CROSS/BLUE SHIELD
KY
01
—
052769029
TRAVERLERS MEDICARE
KY
05
—
64125693
—
KY
01
—
K001463
CHAMPUS
KY
Enumeration date
12/16/2009
Last updated
03/11/2013
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