Individual
DR. LONNIE KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1401 JOHNSON FERRY RD, SUITE 390, MARIETTA, GA 30062-6495
(770) 971-5494
(770) 971-0467
Mailing address
62 OLD STONEMILL RD NE, MARIETTA, GA 30067-4128
(770) 933-3494
(770) 988-8173
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
037255
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52728549014
BLUE CROSS BLUE SHIELD
GA
Enumeration date
07/31/2006
Last updated
07/08/2007
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