Individual
DR. GARY E KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
854 RIDGEWOOD DR., BEREA, KY 40403-9814
(859) 986-7027
(859) 986-4749
Mailing address
109 BOONE ST, BEREA, KY 40403-1603
(859) 986-7027
(859) 986-4749
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0865DT
KY
152W00000X
Optometrist
856DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77008654
—
KY
Enumeration date
10/17/2006
Last updated
09/16/2020
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