Provider Demographics
NPI:1124025846
Name:KING, RICHARD CHRISTIAN (DPM)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:CHRISTIAN
Last Name:KING
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 N ROAD ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-3334
Mailing Address - Country:US
Mailing Address - Phone:252-338-2111
Mailing Address - Fax:252-338-2113
Practice Address - Street 1:1121 N ROAD ST
Practice Address - Street 2:SUITE B
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-3334
Practice Address - Country:US
Practice Address - Phone:252-338-2111
Practice Address - Fax:252-338-2113
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC167213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
243092AOtherMEDICARE
NC08112OtherBCBS
NC7908112Medicaid
480003447OtherRAILROAD MEDICARE
480003447OtherRAILROAD MEDICARE
NC7908112Medicaid