Provider Demographics
NPI:1811356595
Name:KING GEORGE FAMILY DOCTORS, LLC
Entity type:Organization
Organization Name:KING GEORGE FAMILY DOCTORS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRINK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-761-7792
Mailing Address - Street 1:11131 JOURNAL PKWY
Mailing Address - Street 2:
Mailing Address - City:KING GEORGE
Mailing Address - State:VA
Mailing Address - Zip Code:22485-3468
Mailing Address - Country:US
Mailing Address - Phone:540-625-2527
Mailing Address - Fax:
Practice Address - Street 1:11131 JOURNAL PKWY
Practice Address - Street 2:
Practice Address - City:KING GEORGE
Practice Address - State:VA
Practice Address - Zip Code:22485-3468
Practice Address - Country:US
Practice Address - Phone:540-625-2527
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-23
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care