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NPI Code Detail

MEDICARE: JAMIE LEIGH KING M.D.

MEDICARE: JAMIE LEIGH KING M.D.
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
1207Q00000XFamily Medicine Physician66769MT
2207Q00000XFamily Medicine Physician0101257746VA

General Provider Information

NPI Number : 1124381140
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMIE LEIGH KING M.D.
Provider Business Mailing Address
First Line : 856 J CLYDE MORRIS BLVD STE A
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23601-1318
Country : US
Telephone Number : 757-316-5800
Fax Number :
Provider Business Practice Location Address
First Line : 191 FOX HILL RD STE D
Second Line :
City : HAMPTON
State : VA
Zip : 23669-2360
Country : US
Telephone Number : 757-850-7315
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2012
Last Update Date : 07/19/2022

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