Individual
DR. KENNETH RAYMOND KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2101 EXECUTIVE DR, TOWER BOX 56, HAMPTON, VA 23666-2404
(757) 827-6298
(757) 838-0725
Mailing address
2101 EXECUTIVE DR STE 56, HAMPTON, VA 23666-2416
(757) 827-6298
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
19887
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042740
ANTHEM
VA
01
—
1326022880
GROUP NPI#
VA
01
—
1942206651
INDIVIDUAL NPI#
VA
01
—
214292
ANTHEM
VA
01
—
51401
OPTIMA
VA
01
—
C00003
MEDICARE GROUP #
VA
01
—
CN5602
RAILROAD MEDICARE GROUP #
—
Enumeration date
06/27/2005
Last updated
11/27/2007
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