1740586965 NPI number — LOUIS A. KING D.C.P.C.

Table of content: (NPI 1740586965)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740586965 NPI number — LOUIS A. KING D.C.P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LOUIS A. KING D.C.P.C.
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:
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:
1740586965
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/13/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1366
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAKE HAVASU CITY
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
86405-1366
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
928-680-4446
Provider Business Mailing Address Fax Number:
928-680-6565

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2163 BIRCH SQ
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
LAKE HAVASU CITY
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
86403-6757
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-680-4446
Provider Business Practice Location Address Fax Number:
928-680-6565
Provider Enumeration Date:
02/05/2011

Additional Information

Authorized Official

Authorized Official Last Name:
KING
Authorized Official First Name:
LOUIS
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
CHIROPRACTOR
Authorized Official Telephone Number:
928-680-4446

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  4614 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com