Individual
KENNETH B KING
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 GEORGE MCCLAIN DRIVE, BENTON, KY 42025
(270) 527-8626
Mailing address
500 GEORGE MCCLAIN DRIVE, BENTON, KY 42025
(270) 527-8626
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
17956
KY
207R00000X
Internal Medicine Physician
8778
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000198973
BLUE CROSS BLUE SHIELD
KY
01
—
1500
BCBS FEDERAL
—
05
—
64179567
—
KY
Enumeration date
02/02/2006
Last updated
07/08/2007
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