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General NPI Number Information
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NPI Number | 1962853911
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Entity Type | Individual
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Provider Name | MARCY KING PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/30/2016
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Last Update Date | 04/10/2020
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Provider Practice Location Address
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Address Line | 131 GOSHEN ROAD EXT STE 300
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City | RINCON
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State | GA
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Zip | 31326-5590
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Country | US
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Telephone | 912-826-0860
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Fax |
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Provider Business Mailing Address
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Address Line | 1511 WHITEMARSH WAY
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City | SAVANNAH
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State | GA
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Zip | 31410-5228
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Country | US
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Telephone | 618-922-4662
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Fax |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 7950
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License Number State | GA
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