Provider Demographics
NPI:1215983630
Name:KING, WILLIAM F JR (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:F
Last Name:KING
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:105 W SCHOOL HOUSE LN
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-3348
Mailing Address - Country:US
Mailing Address - Phone:215-848-9000
Mailing Address - Fax:215-848-7894
Practice Address - Street 1:105 W SCHOOL HOUSE LN
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-3348
Practice Address - Country:US
Practice Address - Phone:215-848-9000
Practice Address - Fax:215-848-7894
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD056718L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001565820Medicaid
PAMD056718LOtherMD LICENCE
PA9353393OtherCIGNA HMO/PPO
PA10930032OtherCAQH ID#
PA835878OtherHIGHMARK BLUE SIELD
PA835878OtherHIGHMARK BLUE SIELD
PA001565820Medicaid