1659553220 NPI number — DR. APRIL R. KING, OD, LLC

Table of content: (NPI 1659553220)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659553220 NPI number — DR. APRIL R. KING, OD, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR. APRIL R. KING, OD, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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:
1659553220
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/06/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
115 W GRAND AVE STE 120
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RAINBOW CITY
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35906-3268
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-442-9350
Provider Business Mailing Address Fax Number:
256-442-9352

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
115 W GRAND AVE STE 120
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RAINBOW CITY
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35906-3268
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-442-9350
Provider Business Practice Location Address Fax Number:
256-442-9352
Provider Enumeration Date:
12/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
KING
Authorized Official First Name:
APRIL
Authorized Official Middle Name:
R.
Authorized Official Title or Position:
PROVIDER
Authorized Official Telephone Number:
256-442-9350

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  S-B59-TA-771 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 181218 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".




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