Basic Information
| Provider Information | |||||||||
| NPI: | 1801094164 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KING | ||||||||
| FirstName: | MERRITT | ||||||||
| MiddleName: | H. | ||||||||
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| NameSuffix: | III | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3239 | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295023239 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8437777042 | ||||||||
| FaxNumber: | 8437777102 | ||||||||
| Practice Location | |||||||||
| Address1: | 3980 HIGHWAY 9 E | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | LITTLE RIVER | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295668163 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8433993100 | ||||||||
| FaxNumber: | 8433991099 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2007 | ||||||||
| LastUpdateDate: | 11/17/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 36446 | SC | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 276204 | 01 | SC | MEDCOST | OTHER | 3550395 | 01 | SC | CIGNA | OTHER | 969443 | 01 | SC | WELLCARE (LITTLE RIVER LOCATION) | OTHER | SC26908552 | 01 | SC | MEDICARE PTAN | OTHER | 30170356 | 01 | SC | SELECT HEALTH | OTHER | 938098 | 01 | SC | WELLCARE (LORIS LOCATION) | OTHER | 364466 | 05 | SC | MEDICAID | P01298179 | 01 | SC | RAILROAD MEDICARE | OTHER |