Provider Demographics
NPI:1346271426
Name:KING, GERALD W (MD)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:W
Last Name:KING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:581 LEROY GEORGE DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CLYDE
Mailing Address - State:NC
Mailing Address - Zip Code:28721-8085
Mailing Address - Country:US
Mailing Address - Phone:828-452-4131
Mailing Address - Fax:828-452-4095
Practice Address - Street 1:581 LEROY GEORGE DR
Practice Address - Street 2:SUITE 300
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-8085
Practice Address - Country:US
Practice Address - Phone:828-452-4131
Practice Address - Fax:828-452-4095
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2007-01605207X00000X, 207XX0005X
GA037254207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2184201OtherCIGNA
NC5908322Medicaid
NC1562KOtherBCBS OF NC
NC2075389BMedicare PIN
NC2184201OtherCIGNA