Stephen E King

Individual provider Active NPI Case Manager/Care Coordinator · Appomattox, VA

NPI 1154636009 · NPPES record last updated Aug 16, 2010

Key facts

NPI
1154636009
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
11866 Richmond Hwy
Appomattox, VA 24522-7995
Phone
(434) 352-9877
Fax
(434) 352-4321
NPI assigned
Aug 16, 2010
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

11866 Richmond Hwy
Appomattox, VA 24522-7995

Mailing address

PO Box 99
Appomattox, VA 24522-0099
Phone (434) 352-9877

Other identifiers

IdentifierTypeStateIssuer
0102911010MedicaidVA
0102911432MedicaidVA

Other providers in Appomattox, VA

All providers in Appomattox, VA · Case Manager/Care Coordinator in Virginia

Sources for this page

Verify at the official NPI Registry.