Provider Demographics
NPI:1477613933
Name:KING, FELICIA FAYE (DC)
Entity Type:Individual
Prefix:DR
First Name:FELICIA
Middle Name:FAYE
Last Name:KING
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2084 DUNBARTON DR
Mailing Address - Street 2:STE C
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-5021
Mailing Address - Country:US
Mailing Address - Phone:662-836-8893
Mailing Address - Fax:
Practice Address - Street 1:2084 DUNBARTON DR
Practice Address - Street 2:STE C
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-5021
Practice Address - Country:US
Practice Address - Phone:662-836-8893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2017-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1037111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS302I359726Medicare PIN