Provider Demographics
NPI:1952376881
Name:KING, PAUL ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ANTHONY
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 1:830 KEMPSVILLE RD FL 1
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3920
Mailing Address - Country:US
Mailing Address - Phone:757-261-8070
Mailing Address - Fax:757-995-7095
Practice Address - Street 1:830 KEMPSVILLE RD FL 1
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3920
Practice Address - Country:US
Practice Address - Phone:757-261-8070
Practice Address - Fax:757-995-7095
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101232736208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010003814Medicaid
VAPAROtherUSA MANAGED CARE
VA74294OtherSENTARA OPTIMA
NC89066M0Medicaid
VA289611OtherANTHEM
VAPAROtherFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
VA-028OtherTRICARE/CHAMPUS
NCBC/BSOther066M0
VA2115972OtherUHC/MAMSI
VAPAROtherAETNA
VAPAROtherVIRGINIA PREMIER HEALTH
VAPAROtherCORVEL/CORCARE
VAPAROtherMULTIPLAN
VAPAROtherVIRGINIA HEALTH NETWORK
VAPAROtherCIGNA
VAPAROtherMULTIPLAN
VA2115972OtherUHC/MAMSI
VAPAROtherCIGNA