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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