Provider Demographics
NPI:1073361556
Name:KING, ALEIGH RAE (PA-C)
Entity type:Individual
Prefix:MS
First Name:ALEIGH
Middle Name:RAE
Last Name:KING
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4601 PARK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-2290
Mailing Address - Country:US
Mailing Address - Phone:704-323-2131
Mailing Address - Fax:
Practice Address - Street 1:101 DELTA PARK DR
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-3575
Practice Address - Country:US
Practice Address - Phone:704-484-0606
Practice Address - Fax:704-484-8007
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-09
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-15316363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant