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General NPI Number Information
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NPI Number | 1265063580
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Entity Type | Organization
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Legal Business Name | KING'S DAUGHTERS MEDICAL SPECIALTIES, INC.
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Dates
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Enumeration Date | 01/27/2020
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 2930 CARTER AVE
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City | ASHLAND
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State | KY
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Zip | 41101-1943
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Country | US
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Telephone | 606-324-1483
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Fax | 606-329-2612
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Provider Business Mailing Address
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Address Line | PO BOX 2379
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City | ASHLAND
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State | KY
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Zip | 41105-2379
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Country | US
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Telephone | 606-408-6200
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Fax | 606-408-6612
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Authorized Official
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Title or Position | CEO
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Name | SARA MARKS
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Credential |
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Telephone | 606-408-4401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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