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Organization

RICHARD W. KING JR, MD

Active
Parent organization
RICHARD W. KING JR, MD
Organization subpart
Yes

Provider details

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

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
021872
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00875201A
GA
Enumeration date
05/27/2010
Last updated
05/27/2010
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