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General NPI Number Information
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NPI Number | 1053479261
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Entity Type | Individual
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Provider Name | DIANE L. KING M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 01/23/2015
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Provider Practice Location Address
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Address Line | 6200 STATION DR
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City | BEALETON
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State | VA
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Zip | 22712-9374
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Country | US
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Telephone | 540-439-8100
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Fax | 540-439-8797
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Provider Business Mailing Address
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Address Line | 550 HOSPITAL DR
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City | WARRENTON
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State | VA
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Zip | 20186-3027
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Country | US
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Telephone | 540-316-5940
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Fax | 540-316-5941
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 0101045014
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License Number State | VA
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