Individual
CARROLL J. KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., J.D.
Contact information
Practice address
404 KEENE ST, COLUMBIA, MO 65201-6626
(573) 219-4270
(573) 219-4279
Mailing address
PO BOX 7687, COLUMBIA, MO 65205-7687
(573) 219-4270
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
40586
TX
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
1033
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
169404401
—
TX
Enumeration date
09/21/2006
Last updated
10/12/2011
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