Provider Demographics
NPI:1447316005
Name:KING, WILLIAM A (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:A
Last Name:KING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:PARK HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41011-2888
Mailing Address - Country:US
Mailing Address - Phone:859-261-4243
Mailing Address - Fax:859-261-2881
Practice Address - Street 1:1510 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:PARK HILLS
Practice Address - State:KY
Practice Address - Zip Code:41011-2888
Practice Address - Country:US
Practice Address - Phone:859-261-4243
Practice Address - Fax:859-261-2881
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2511C111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY8500136000Medicaid
KY8500136000Medicaid
KY6017001Medicare ID - Type Unspecified