Provider Demographics
NPI:1518989664
Name:KING, WILLIAM PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:PAUL
Last Name:KING
Suffix:
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 1:3611 PINNACLE RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72936-9142
Mailing Address - Country:US
Mailing Address - Phone:479-996-7187
Mailing Address - Fax:
Practice Address - Street 1:7301 ROGERS AVE.
Practice Address - Street 2:ST. EDWARD MERCY MEDICAL CENTER EMERGENCY ROOM
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903
Practice Address - Country:US
Practice Address - Phone:479-314-6241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR-3139207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF9671OtherTEX. STATE LIC. NO.
ARR-3139OtherARK. STATE LIC. NO.
ARR-3139OtherARK. STATE LIC. NO.
ARR-3139OtherARK. STATE LIC. NO.
TXF9671OtherTEX. STATE LIC. NO.