Provider Demographics
NPI:1285057620
Name:KING, GAIL (PHARM D, MBA)
Entity type:Individual
Prefix:DR
First Name:GAIL
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:PHARM D, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 ZEAGLER DR
Mailing Address - Street 2:
Mailing Address - City:PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32177-3810
Mailing Address - Country:US
Mailing Address - Phone:386-326-8451
Mailing Address - Fax:386-326-8484
Practice Address - Street 1:611 ZEAGLER DR
Practice Address - Street 2:
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-3810
Practice Address - Country:US
Practice Address - Phone:386-326-8451
Practice Address - Fax:386-326-8484
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-21
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS16763183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist