Healthcare Provider Details

I. General information

NPI: 1801094164
Provider Name (Legal Business Name): MERRITT H. KING III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2007
Last Update Date: 12/23/2024
Certification Date: 12/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3980 HIGHWAY 9 E SUITE 110
LITTLE RIVER SC
29566-8163
US

IV. Provider business mailing address

PO BOX 3239
FLORENCE SC
29502-3239
US

V. Phone/Fax

Practice location:
  • Phone: 843-399-3100
  • Fax: 843-399-1099
Mailing address:
  • Phone: 843-777-7042
  • Fax: 843-777-7102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number2009-00460
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number36446
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: