Individual
LISA KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5100 OUTER LOOP, LOUISVILLE, KY 40219-4056
(502) 968-6226
(502) 966-5562
Mailing address
6801 DIXIE HWY, SUITE 130, LOUISVILLE, KY 40258-3913
(502) 968-6226
(502) 966-5562
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
45295
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2731509-00
—
FL
05
—
7100203510
—
KY
Enumeration date
08/01/2006
Last updated
07/29/2013
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