Provider Demographics
NPI:1659553220
Name:DR. APRIL R. KING, OD, LLC
Entity Type:Organization
Organization Name:DR. APRIL R. KING, OD, LLC
Other - Org Name:VISION SOURCE OF RAINBOW CITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:R
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:256-442-9350
Mailing Address - Street 1:115 W GRAND AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:RAINBOW CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35906-3268
Mailing Address - Country:US
Mailing Address - Phone:256-442-9350
Mailing Address - Fax:256-442-9352
Practice Address - Street 1:115 W GRAND AVE STE 120
Practice Address - Street 2:
Practice Address - City:RAINBOW CITY
Practice Address - State:AL
Practice Address - Zip Code:35906-3268
Practice Address - Country:US
Practice Address - Phone:256-442-9350
Practice Address - Fax:256-442-9352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-05
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-B59-TA-771152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL181218Medicaid