Provider Demographics
NPI:1801094164
Name:KING, MERRITT H III (MD)
Entity type:Individual
Prefix:
First Name:MERRITT
Middle Name:H
Last Name:KING
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PO BOX 3239
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29502-3239
Mailing Address - Country:US
Mailing Address - Phone:843-777-7042
Mailing Address - Fax:843-777-7102
Practice Address - Street 1:3980 HIGHWAY 9 E
Practice Address - Street 2:SUITE 110
Practice Address - City:LITTLE RIVER
Practice Address - State:SC
Practice Address - Zip Code:29566-8163
Practice Address - Country:US
Practice Address - Phone:843-399-3100
Practice Address - Fax:843-399-1099
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2009-004602084A0401X
SC36446207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC364466Medicaid
SCSC26908552OtherMEDICARE PTAN
SC276204OtherMEDCOST
SC938098OtherWELLCARE (LORIS LOCATION)
SC969443OtherWELLCARE (LITTLE RIVER LOCATION)
SC3550395OtherCIGNA
SC30170356OtherSELECT HEALTH
SCP01298179OtherRAILROAD MEDICARE