| Organization Name: | KING'S MEDICAL IMAGING AT WATERMARK, LLC |
| NPI Number: | 1316075179 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILLIAM E. BEATTIE (COO) |
| Mailing Address: | 5339 Hendron Rd Groveport |
| State: | OH US |
| Postal Code: | 431251055 |
| Phone Number: | 6148350358 |
| Fax Number: | 6148350712 |
| NPI Enumeration Date: | 03/01/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 293D00000X |
| License Number: | NA |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Laboratories |
| Taxonomy Classification: | Physiological Laboratory |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A laboratory that operates independently of a hospital and physician |