Provider Demographics
NPI:1174733620
Name:KING, KEVIN P (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:P
Last Name:KING
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:816 S KIRKWOOD RD STE 210
Mailing Address - Street 2:
Mailing Address - City:KIRKWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63122-6056
Mailing Address - Country:US
Mailing Address - Phone:314-822-6830
Mailing Address - Fax:314-822-6859
Practice Address - Street 1:816 S KIRKWOOD RD STE 210
Practice Address - Street 2:
Practice Address - City:KIRKWOOD
Practice Address - State:MO
Practice Address - Zip Code:63122-6056
Practice Address - Country:US
Practice Address - Phone:314-822-6830
Practice Address - Fax:314-822-6859
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2010-02-18
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Provider Licenses
StateLicense IDTaxonomies
MO2008005698207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine