Glen R King, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

33127 Issued in GA

Practice address

40 Fox Chase
Cartersville, GA 30120-2491

Phone

(770) 382-0185

Fax

(770) 382-0247

NPI assigned

Jun 15, 2009

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Endocrine Specialists of Georgia, LLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Cartersville, GA
  • NPI 1902407307
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356048000000",
    "number": "1750518023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2016",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301201684",
            "telephone_number": "770-382-0185",
            "fax_number": "770-382-0247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 FOX CHASE",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301202491",
            "telephone_number": "770-382-0185",
            "fax_number": "770-382-0247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "GLEN",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-15",
        "last_updated": "2012-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "33127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert E Kim, MD
• Rosalid Kimani
• Tony Ray Kincannon
• Joryell Kinchen-Miller
• Janice King-Heard
• Laura Poulsen King, CRNA
• Catherine Claire Kiser, DC
• Cody Daniel Klette, CPNP-PC
• Maryana Kleyn, LCSW
• Brandi D Knight, FNP

• Family Medicine Physician in Cartersville, GA
• Providers in Cartersville, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.