Provider Demographics
NPI:1194795377
Name:KING, KURT W (MD)
Entity type:Individual
Prefix:
First Name:KURT
Middle Name:W
Last Name:KING
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5000 WATERDAM PLAZA DR
Mailing Address - Street 2:SUITE 180
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-5412
Mailing Address - Country:US
Mailing Address - Phone:724-942-4372
Mailing Address - Fax:724-942-4373
Practice Address - Street 1:455 VALLEY BROOK RD STE 300
Practice Address - Street 2:
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-3367
Practice Address - Country:US
Practice Address - Phone:724-941-5588
Practice Address - Fax:724-941-1458
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2023-06-12
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Provider Licenses
StateLicense IDTaxonomies
PAMD071244L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001806479Medicaid
PA001806479Medicaid
PA030479Medicare PIN