Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 38511 | KY |
Y | 207Q00000X | Family Doctor | ME125780 | FL |
N | 207QA0401X | Family Doctor - Addiction Medicine | 38511 | KY |
N | 207QA0505X | Family Doctor - Adult Medicine | 38511 | KY |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 38511 | KY |
N | 207QS0010X | Family Doctor - Sports Medicine | 38511 | KY |
N | 207VX0000X | Obstetrician | 38511 | KY |
NPI | 1578591095 |
---|---|
Provider Name | Michael Rhea King |
First Address | Brooksville, FL 34613-5409 |
Second Address | Brooksville, FL 34601-3215 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2006 |
Last Update Date | 03/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64081045 | (05) | KY |
H90494 | (02) |