Provider Demographics
NPI:1336662758
Name:KING, KAY D
Entity Type:Individual
Prefix:
First Name:KAY
Middle Name:D
Last Name:KING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9215 N SUGAR FOOT DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85743-5206
Mailing Address - Country:US
Mailing Address - Phone:520-744-5841
Mailing Address - Fax:520-744-5841
Practice Address - Street 1:9215 N SUGAR FOOT DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85743-5206
Practice Address - Country:US
Practice Address - Phone:520-744-5841
Practice Address - Fax:520-744-5841
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11509183500000X
AZS12422183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist