Provider Demographics
NPI:1538451687
Name:KING, JAMES M (PA)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:KING
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:602 E 72ND ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4913
Mailing Address - Country:US
Mailing Address - Phone:912-819-7878
Mailing Address - Fax:912-819-7850
Practice Address - Street 1:11909D MCAULEY DRIVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31419-1794
Practice Address - Country:US
Practice Address - Phone:912-927-0785
Practice Address - Fax:912-927-6572
Is Sole Proprietor?:No
Enumeration Date:2011-05-09
Last Update Date:2012-09-13
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Provider Licenses
StateLicense IDTaxonomies
GA006093363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA006093OtherGA P.A. LICENSE