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General NPI Number Information
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NPI Number | 1033211396
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Entity Type | Organization
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Legal Business Name | LEWIS R. KING, MD
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Dates
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Enumeration Date | 09/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 602 N TITUS
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City | GILMER
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State | TX
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Zip | 75644
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Country | US
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Telephone | 903-843-2210
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Fax | 903-843-2212
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Provider Business Mailing Address
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Address Line | 602 N TITUS
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City | GILMER
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State | TX
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Zip | 75644
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Country | US
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Telephone | 903-843-2210
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Fax | 903-843-2212
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | BETTY J MCELROY
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Credential |
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Telephone | 903-232-8501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | J2129
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License Number State | TX
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