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NPI Code Detail

MEDICARE: ELIZABETH L KING M.D.

MEDICARE: ELIZABETH L 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
1208000000XPediatrics PhysicianME91162FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679505580
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH L KING M.D.
Provider Business Mailing Address
First Line : 2478 13TH ST SE
Second Line :
City : SALEM
State : OR
Zip : 97302-2522
Country : US
Telephone Number : 503-362-2481
Fax Number : 503-371-7803
Provider Business Practice Location Address
First Line : 2478 13TH ST SE
Second Line :
City : SALEM
State : OR
Zip : 97302-2522
Country : US
Telephone Number : 503-362-2481
Fax Number : 503-371-7803
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2006
Last Update Date : 08/30/2013

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