| Doctor Name: | MARK B KINGSTON |
| NPI Number: | 1942296405 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 20555 |
| Business Practice Address: | 203 S Water St Louisa, KY - 412301387 |
| Business Phone Number: | 6066384504 |
| Business Fax Number: | 6066384186 |
| Mailing Address: | 203 S Water St, Po Box 120 LOUISA |
| State: | KY |
| Postal Code: | 412301387 |
| Phone Number: | 6066384504 |
| Fax Number: | 6066384186 |
| NPI Enumeration Date: | 09/21/2005 |
| NPI Last Update Date: | 11/11/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 20555 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |