Organization
EMERALD COAST EMERGENCY PHYSICIANS LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DERIK K KING MD (LLP MANAGING PARTNER)
(866) 916-5259
Entity
Organization
Contact information
Practice address
2190 HIGHWAY 85 N, NICEVILLE, FL 32578-1045
(850) 678-4131
(850) 729-9473
Mailing address
PO BOX 602162, CHARLOTTE, NC 28260-2162
(866) 916-5259
(231) 922-4030
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000625800
—
FL
01
—
72205
BLUE SHIELD
FL
Enumeration date
12/11/2008
Last updated
06/17/2009
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