Individual provider · NPI-1
Kevin Richard King, MD
Hospitalist · Phenix City, AL
NPI number1104808294
StatusActive
Last updated in NPPESApr 12, 2021
Details
- NPI
- 1104808294
- Entity type
- Individual (NPI-1)
- Name
- Kevin Richard King
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 15, 2005
- Certification date
- Apr 12, 2021
- Last updated
- Apr 12, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208M00000X | Hospitalist | 42356 | AL | Yes |
| 208M00000X | Hospitalist | 056310 | GA |
Practice location
4401 Riverchase DrPhenix City, AL 36867-7483
Phone 334-732-3000 · Fax 706-494-3008
Mailing address
Po Box 370Fortson, GA 31808-0370
Phone 706-494-3072 · Fax 706-494-3008
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