Doctor Name: | THU-TRANG CLEO THI KING |
NPI Number: | 1023029931 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA |
License Number: | PA962 |
Business Practice Address: | 2501 Kentucky Ave Paducah, KY - 420033813 |
Business Phone Number: | 2705752180 |
Business Fax Number: | 2705758479 |
Mailing Address: | Po Box 9150, PADUCAH |
State: | KY |
Postal Code: | 420029150 |
Phone Number: | 2707449600 |
Fax Number: | 2707440834 |
NPI Enumeration Date: | 08/10/2006 |
NPI Last Update Date: | 12/10/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA962 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | KY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |