1053263251 NPI number — WILLIAM GREGORY KING PTA

Table of content: WILLIAM GREGORY KING PTA (NPI 1053263251)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053263251 NPI number — WILLIAM GREGORY KING PTA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KING
Provider First Name:
WILLIAM
Provider Middle Name:
GREGORY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PTA
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KING
Provider Other First Name:
GREG
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PTA
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1053263251
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/10/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1982 BURNING BUSH RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RINGGOLD
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30736-5357
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-315-9200
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1035 RED BUD RD NE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CALHOUN
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30701-6010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-602-7800
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/10/2026

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225200000X , with the licence number:  PTA004030 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)