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Individual

KEVIN RICHARD KING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4401 RIVERCHASE DR, PHENIX CITY, AL 36867-7483
(334) 732-3000
(706) 494-3008
Mailing address
PO BOX 370, FORTSON, GA 31808-0370
(706) 494-3072
(706) 494-3008

Taxonomy

Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
056310
GA
208M00000X
Hospitalist Physician
Primary
42356
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
633050776E
GA
Enumeration date
11/15/2005
Last updated
04/12/2021
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