MEDICARE: ROBERT L KING

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	225X00000X	Occupational Therapist	0977	AL

General Provider Information

NPI Number	:	1538366182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT L KING

Provider Business Mailing Address
First Line	:	3407 WAVERLY DR
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35209-5552
Country	:	US
Telephone Number	:	205-870-1184
Fax Number	:

Provider Business Practice Location Address
First Line	:	2204 LAKESHORE DR
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35209-6729
Country	:	US
Telephone Number	:	205-868-0147
Fax Number	:

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

Provider Enumeration Date	:	06/28/2007
Last Update Date	:	07/08/2007

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Directions to “ ROBERT L KING ” Practice Location

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