Provider Demographics
NPI:1275573347
Name:KING, DONNA USHER (DC, CCSP)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:USHER
Last Name:KING
Suffix:
Gender:F
Credentials:DC, CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 PEMBERTON HILL RD
Mailing Address - Street 2:STE 103
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-3957
Mailing Address - Country:US
Mailing Address - Phone:919-363-2225
Mailing Address - Fax:919-363-2280
Practice Address - Street 1:1101 PEMBERTON HILL RD
Practice Address - Street 2:STE 103
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-3957
Practice Address - Country:US
Practice Address - Phone:919-363-2225
Practice Address - Fax:919-363-2280
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2050111N00000X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1457539538Medicaid
NC08716OtherBCBSNC ID NUMBER
NCU55303Medicare UPIN
NC2449232Medicare PIN