King, Kelly E

King, Kelly E is an individual health care provider with primary practice located at 3600 Joseph Siewick Dr , Fairfax VA 22033. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medical Services, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. King, Kelly E can be contacted via phone (703) 391-3600.

Contact Information

Primary practice address
3600 Joseph Siewick Dr Fairfax VA 22033
Phone: (703) 391-3600
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 0101054870 Virginia
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 0101054870 Virginia

Profile Details

NPI number 1861408932
LBN Legal business name King, Kelly E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 31st, 2006
Last updated Jul 28th, 2020 - about 4 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 1861408932 NPPES
Virginia MEDICAID 010113261

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