| Paul King Md Pc | |
|
9075 Sandidge Center Dr Olive Branch MS 38654 | |
| (662) 893-7101 | |
| (662) 895-4403 |
| Full Name | Paul King Md Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 9075 Sandidge Center Dr, Olive Branch, Mississippi |
| Authorized Official Name and Position | Paul King (PHYSICIAN) |
| Authorized Official Contact | 6628937101 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paul King Md Pc Po Box 341065 Memphis TN 38184 Ph: (901) 385-2342 | Paul King Md Pc 9075 Sandidge Center Dr Olive Branch MS 38654 Ph: (662) 893-7101 |
| NPI Number | 1649362518 |
|---|---|
| Provider Enumeration Date | 09/29/2006 |
| Last Update Date | 01/04/2008 |
| Medicare PECOS PAC ID | 4486721420 |
|---|---|
| Medicare Enrollment ID | O20080917000491 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649362518 | NPI | - | NPPES |
| 00853276 | Medicaid | MS | |
| 16134 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 12763 (Mississippi) | Primary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 10676 (Tennessee) | Secondary |
| Provider Name | Paul King |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548423718 PECOS PAC ID: 7214004258 Enrollment ID: I20080917000484 |
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