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General NPI Number Information
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NPI Number | 1326201500
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Entity Type | Organization
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Legal Business Name | TERRY D. KING, MD AMC
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Dates
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Enumeration Date | 07/08/2008
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Last Update Date | 05/22/2012
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Provider Practice Location Address
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Address Line | 300 PAVILION RD
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City | WEST MONROE
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State | LA
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Zip | 71292-9470
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Country | US
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Telephone | 318-323-1100
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Fax | 318-323-1161
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Provider Business Mailing Address
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Address Line | 300 PAVILION RD
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City | WEST MONROE
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State | LA
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Zip | 71292-9470
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Country | US
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Telephone | 318-323-1100
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Fax | 318-323-1161
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Authorized Official
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Title or Position | CFO
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Name | NANCY BATSON KING
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Credential | PNP-BC
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Telephone | 318-323-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | MD.02443R
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License Number State | LA
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