Individual
GEORGE RANDY KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
425 BROADWAY ST, PADUCAH, KY 42001-0713
(270) 442-7121
Mailing address
425 BROADWAY, PADUCAH, KY 42001
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0597
ALC & DRUG COUNSELOR
KY
Enumeration date
12/20/2006
Last updated
02/24/2009
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