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General NPI Number Information
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NPI Number | 1881652469
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Entity Type | Organization
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Legal Business Name | WALTER L. KING, MD
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 06/17/2013
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Provider Practice Location Address
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Address Line | 336 10TH AVE NE
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City | HICKORY
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State | NC
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Zip | 28601-3834
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Country | US
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Telephone | 828-322-4973
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Fax | 828-322-1636
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Provider Business Mailing Address
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Address Line | 336 10TH AVE NE
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City | HICKORY
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State | NC
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Zip | 28601-3834
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Country | US
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Telephone | 828-322-4973
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Fax | 828-322-1636
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | DR. WALTER LEE KING SR.
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Credential | MD
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Telephone | 828-322-4973
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1831
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 17219
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License Number State | NC
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