Provider Demographics
NPI:1417182429
Name:KING, WILLIAM III (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:KING
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6305
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93031-6305
Mailing Address - Country:US
Mailing Address - Phone:805-988-0616
Mailing Address - Fax:805-604-1722
Practice Address - Street 1:2001 SOLAR DR
Practice Address - Street 2:SUITE 135
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2645
Practice Address - Country:US
Practice Address - Phone:805-988-0616
Practice Address - Fax:805-604-1722
Is Sole Proprietor?:No
Enumeration Date:2009-05-19
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG307912085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E37917Medicare UPIN