Provider Demographics
NPI:1235908039
Name:KING, JAMES LOUIS
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:LOUIS
Last Name:KING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9251 LOTTSFORD RD APT 1H
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-3770
Mailing Address - Country:US
Mailing Address - Phone:202-500-6567
Mailing Address - Fax:
Practice Address - Street 1:6323 GEORGIA AVE NW STE 200
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-1141
Practice Address - Country:US
Practice Address - Phone:202-525-3954
Practice Address - Fax:202-330-5245
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-21
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator