Provider Demographics
NPI:1831243153
Name:GAIL KING MD PC
Entity type:Organization
Organization Name:GAIL KING MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL CODER, BILLER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:YOST
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:970-945-1443
Mailing Address - Street 1:PO BOX 111
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81602-0111
Mailing Address - Country:US
Mailing Address - Phone:970-945-1443
Mailing Address - Fax:970-947-9410
Practice Address - Street 1:605 W MAIN ST
Practice Address - Street 2:#103
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611-1648
Practice Address - Country:US
Practice Address - Phone:970-925-8005
Practice Address - Fax:970-920-1652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO77428064Medicaid
CO77428064Medicaid