Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 35.121515 | OH |
NPI | 1013178227 |
---|---|
Provider Name | Ashley B. King |
First Address | Pensacola, FL 32504-7841 |
Second Address | Pensacola, FL 32503-2339 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2008 |
Last Update Date | 24/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
014845300 | (05) | FL |