1467560391 NPI number — MARTHA KING MCKAY MD

Table of content: MARTHA KING MCKAY MD (NPI 1467560391)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467560391 NPI number — MARTHA KING MCKAY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCKAY
Provider First Name:
MARTHA
Provider Middle Name:
KING
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467560391
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/04/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
119 HENDERSONVILLE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28803-2868
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-257-4730
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
123 HENDERSONVILLE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ASHEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28803
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-257-4730
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/29/2006

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: 207R00000X , with the licence number:  39031 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1467560391 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3400011 . This is a "MEDICAID OSCAR" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 0081P . This is a "BCBS SWINGBED" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 014MX . This is a "BLUE CROSS LABS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 235013 . This is a "MEDICARE PHYSICIAN" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 00513 . This is a "BLUE CROSS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 34U011 . This is a "MEDICARE SWINGBED" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 07673 . This is a "BLUE CROSS PHYSICIAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 411013849 . This is a "RAILRAOD MEDICARE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 235013B . This is a "MEDICARE PHYSICIAN" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 56968 . This is a "BCBS INDIVIDUAL PROVIDER" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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