Provider Demographics
NPI:1245271287
Name:KING, WILLIAM W (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:W
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 1:120 AKERS FARM RD, NE
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073
Mailing Address - Country:US
Mailing Address - Phone:540-382-3440
Mailing Address - Fax:
Practice Address - Street 1:120 AKERS FARM RD, NE
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073
Practice Address - Country:US
Practice Address - Phone:540-382-3440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101016917208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VACF8401OtherRAILROAD MEDICARE
VA7554206Medicaid
VA0196190002Medicare NSC
VACF8401OtherRAILROAD MEDICARE
VA7554206Medicaid
NC010458P95Medicare PIN