Organization
BACKPACK MEDICAL GROUP OF KS ASSOCIATION
Active
Organization
BACKPACK MEDICAL GROUP OF KS ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOSHAWN KING (INSURANCE SPECIALIST)
(407) 779-5617
Entity
Organization
Contact information
Practice address
6655 SANTA BARBARA RD UNIT 8574, ELKRIDGE, MD 21075-7523
(630) 306-4394
Mailing address
6655 SANTA BARBARA RD UNIT 8574, ELKRIDGE, MD 21075-7523
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
Other
Enumeration date
07/22/2024
Last updated
03/12/2025
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