King, Elizabeth

King, Elizabeth is an individual health care provider with primary practice located at 2621 S Green Bay Rd , Racine WI 53406-4948. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. King, Elizabeth can be contacted via phone (262) 504-6150.

Contact Information

Primary practice address
2621 S Green Bay Rd Racine WI 53406-4948
Phone: (262) 504-6150
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036135031 Illinois
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 110210 California
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 69041 Wisconsin

Profile Details

NPI number 1649478843
LBN Legal business name King, Elizabeth
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2007
Last updated May 26th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649478843 NPPES
Wisconsin MEDICAID 100081420

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