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Individual

MALCOLM H KING

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.P.S.C.

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 41101-2873
(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 SH
KY
05
64125693
KY
01
K001463
CHAMPUS
KY
Enumeration date
04/06/2006
Last updated
07/08/2007
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