Provider Demographics
NPI:1316180508
Name:KING, LAQUITA KIMBERLY (MD)
Entity Type:Individual
Prefix:DR
First Name:LAQUITA
Middle Name:KIMBERLY
Last Name:KING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:575 BEECH ST
Mailing Address - Street 2:DEPARTMENT OF PATHOLOGY
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-2223
Mailing Address - Country:US
Mailing Address - Phone:413-534-2583
Mailing Address - Fax:
Practice Address - Street 1:575 BEECH ST
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-2223
Practice Address - Country:US
Practice Address - Phone:413-534-2583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-17
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA26601207ZP0102X
SC13282207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology