Individual
RICKEY DUWAYNE KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
280 MAPLE ST, ASHLAND, OR 97520-1552
(541) 201-4000
(253) 944-7922
Mailing address
PO BOX 4749, MEDFORD, OR 97501-0227
(541) 789-5516
(541) 789-5538
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD00039954
WA
207P00000X
Emergency Medicine Physician
Primary
MD150570
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0170820
LIWA
WA
01
—
0170830
LIWA
WA
01
—
1186KI
BSWA
WA
01
—
4968KI
BSWA
WA
05
—
8283921
—
WA
Enumeration date
06/22/2006
Last updated
07/28/2014
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