Individual
DR. EMILY LOUISE KINGSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
170 MEDICAL PARK RD STE 205, MOORESVILLE, NC 28117-8540
(704) 664-4679
(704) 761-6988
Mailing address
PO BOX 1845, STATESVILLE, NC 28687-1845
(704) 873-4277
(704) 978-3549
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2012-01586
NC
208000000X
Pediatrics Physician
2012-01586
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
232009
MEDICARE PTAN, GROUP
NC
05
—
5921857
—
NC
Enumeration date
06/19/2008
Last updated
06/08/2023
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