Provider Demographics
NPI:1780687269
Name:KING, GREGORY A (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:A
Last Name:KING
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:367 WEST EVANS STREET
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-3429
Mailing Address - Country:US
Mailing Address - Phone:843-669-4156
Mailing Address - Fax:843-664-2121
Practice Address - Street 1:365 W WESMARK BLVD
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-1987
Practice Address - Country:US
Practice Address - Phone:803-905-8020
Practice Address - Fax:803-905-8025
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2024-02-14
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Provider Licenses
StateLicense IDTaxonomies
SC22324207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC223243Medicaid
SCS327578OtherCIGNA
SC20027625OtherSELECT HEALTH
SC5467484OtherAETNA
SC9624212OtherGHI
SC433662OtherPRIVATE HEALTHCARE SYSTEM
SC180041867OtherRAILROAD MEDICARE
SCG49193Medicare UPIN