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General NPI Number Information
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NPI Number | 1629497888
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Entity Type | Individual
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Provider Name | MAURICE L. KING III MD
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Gender | Male
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Dates
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Enumeration Date | 04/15/2014
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 4950 ESSEN LN
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City | BATON ROUGE
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State | LA
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Zip | 70809-3738
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Country | US
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Telephone | 225-767-0847
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Fax | 225-767-1335
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Provider Business Mailing Address
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Address Line | 5215 ESSEN LN STE 200
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City | BATON ROUGE
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State | LA
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Zip | 70809-3543
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Country | US
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Telephone | 225-215-1281
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Fax | 225-215-1380
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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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 324018
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License Number State | LA
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