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Individual

DR. MALCOLM A KING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.P.S.C.

Contact information

Practice address
613 23RD ST, SUITE 230, ASHLAND, KY 41101-2878
(606) 324-4745
(606) 324-4941
Mailing address
PO BOX 2379, ASHLAND, KY 41105-2379
(606) 324-4745
(606) 324-4941

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
24195
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000049114
ANTHEM/BLUE CROSS/BLUE SH
KY
05
0085561000
WV
05
0690542
OH
01
110028144
TRAVELERS MEDICARE
KY
01
611140483
COMMERCIAL
KY
05
64241953
KY
01
K011087
CHAMPUS
KY
Enumeration date
04/06/2006
Last updated
02/28/2014
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