Paul King Md Pc | |
9075 Sandidge Center Dr Olive Branch MS 38654 | |
(662) 893-7101 | |
(662) 895-4403 |
Full Name | Paul King Md Pc |
---|---|
Speciality | Psychiatry & Neurology |
Location | 9075 Sandidge Center Dr, Olive Branch, Mississippi |
Authorized Official Name and Position | Paul King (PHYSICIAN) |
Authorized Official Contact | 6628937101 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Paul King Md Pc Po Box 341065 Memphis TN 38184 Ph: (901) 385-2342 | Paul King Md Pc 9075 Sandidge Center Dr Olive Branch MS 38654 Ph: (662) 893-7101 |
NPI Number | 1649362518 |
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Provider Enumeration Date | 09/29/2006 |
Last Update Date | 01/04/2008 |
Medicare PECOS PAC ID | 4486721420 |
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Medicare Enrollment ID | O20080917000491 |
Identifier | Type | State | Issuer |
---|---|---|---|
1649362518 | NPI | - | NPPES |
00853276 | Medicaid | MS | |
16134 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | 12763 (Mississippi) | Primary |
2084P0800X | Psychiatry & Neurology - Psychiatry | 10676 (Tennessee) | Secondary |
Provider Name | Paul King |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1548423718 PECOS PAC ID: 7214004258 Enrollment ID: I20080917000484 |
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