Individual
COLEMAN T. KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
587 FURYS FERRY RD, MARTINEZ, GA 30907
(706) 721-8623
Mailing address
1120 15TH ST STE BI1056, AUGUSTA, GA 30912-0004
(706) 721-3813
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
040122
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000669644F
—
GA
05
—
G40122
—
SC
Enumeration date
09/06/2006
Last updated
05/01/2019
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