King, Rae A

King, Rae A is an individual health care provider with primary practice located at 750 Townpark Ln Nw , Kennesaw GA 30144-5579. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. King, Rae A can be contacted via phone (770) 514-5500.

Contact Information

Primary practice address
750 Townpark Ln Nw Kennesaw GA 30144-5579
Phone: (770) 514-5500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 053319 Georgia

Profile Details

NPI number 1750383691
LBN Legal business name King, Rae A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2005
Last updated Jan 13th, 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 1750383691 NPPES
Georgia MEDICAID 593568511L
Georgia MEDICAID 593568511K
Georgia MEDICAID 593568511N
Georgia MEDICAID 593568511O
Georgia MEDICAID 593568511M

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