Provider Demographics
NPI:1093805525
Name:DAVIS R KING MD INC.
Entity Type:Organization
Organization Name:DAVIS R KING MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ANESTHESIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVIS
Authorized Official - Middle Name:ROLAND
Authorized Official - Last Name:KING
Authorized Official - Suffix:I
Authorized Official - Credentials:MD
Authorized Official - Phone:808-874-6877
Mailing Address - Street 1:PO BOX 392
Mailing Address - Street 2:
Mailing Address - City:KULA
Mailing Address - State:HI
Mailing Address - Zip Code:96790-0392
Mailing Address - Country:US
Mailing Address - Phone:808-874-6877
Mailing Address - Fax:
Practice Address - Street 1:239 HOOHANA ST
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-2452
Practice Address - Country:US
Practice Address - Phone:808-874-6877
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD3544261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH0000BDLXVMedicare PIN