Individual
MRS. MARITA KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
960 JOHNSON FERRY RD, STE 500, ATLANTA, GA 30342-1631
(404) 257-0006
(404) 851-1316
Mailing address
960 JOHNSON FERRY RD, STE 500, ATLANTA, GA 30342-1631
(404) 257-0006
(404) 851-1316
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7934
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003176842A
—
GA
Enumeration date
04/04/2016
Last updated
10/16/2020
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