Provider Demographics
NPI:1326104043
Name:KING, RONALD L (NP)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:L
Last Name:KING
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 W SALISBURY ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203-5497
Mailing Address - Country:US
Mailing Address - Phone:336-636-5100
Mailing Address - Fax:336-636-5144
Practice Address - Street 1:515 W SALISBURY ST
Practice Address - Street 2:SUITE D
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-5497
Practice Address - Country:US
Practice Address - Phone:336-636-5100
Practice Address - Fax:336-636-5144
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5005529363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q67186Medicare UPIN