MEDICARE: DR. RICHARD CHRISTIAN KING D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	167	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	243092A	OTHER		MEDICARE
4	480003447	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	08112	OTHER	NC	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124025846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD CHRISTIAN KING D.P.M.

Provider Business Mailing Address
First Line	:	1121 N ROAD ST
Second Line	:	SUITE B
City	:	ELIZABETH CITY
State	:	NC
Zip	:	27909-3334
Country	:	US
Telephone Number	:	252-338-2111
Fax Number	:	252-338-2113

Provider Business Practice Location Address
First Line	:	1121 N ROAD ST
Second Line	:	SUITE B
City	:	ELIZABETH CITY
State	:	NC
Zip	:	27909-3334
Country	:	US
Telephone Number	:	252-338-2111
Fax Number	:	252-338-2113

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	10/31/2011

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Directions to “ DR. RICHARD CHRISTIAN KING D.P.M.” Practice Location

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