Provider Demographics
NPI:1114957263
Name:KING, GARLAND COFFIELD (MD)
Entity Type:Individual
Prefix:
First Name:GARLAND
Middle Name:COFFIELD
Last Name:KING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 MEDICAL PARK DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-2632
Mailing Address - Country:US
Mailing Address - Phone:828-369-4407
Mailing Address - Fax:828-369-4408
Practice Address - Street 1:56 MEDICAL PARK DR
Practice Address - Street 2:SUITE 301
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-2632
Practice Address - Country:US
Practice Address - Phone:828-369-4407
Practice Address - Fax:828-369-4408
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26449207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8949112Medicaid
NC8949112Medicaid
NC207873AMedicare ID - Type Unspecified