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Contact Information

KING CITY PHYSICIAN COMPANY, LLC
4117 S WATER TOWER PL
SUITE C
MOUNT VERNON, IL62864-6567
 Phone: 618-242-0672
 Fax: 618-242-0862
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic Surgery within the Head & Neck

207YX0007X 04 Physician/Otolaryngology
 

Adolescent Medicine

2080A0000X 37 Physician/Pediatric Medicine
 

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
 

Family

363LF0000X 50 Nurse Practitioner
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Physician Assistant

363A00000X 97 Physician Assistant
 

Pulmonary Disease

207RP1001X 11 Physician/Internal Medicine
 

Surgery

208600000X 02 Physician/General Surgery
 

Urology

208800000X 34 Physician/Urology
Indicates primary specialty

NPI Profile & details for KING CITY PHYSICIAN COMPANY, LLC

NPI Number 1134470859
LBN Legal business name KING CITY PHYSICIAN COMPANY, LLC
Authorized official LAURA FEY - (SR. DIRECTOR PHYSICIAN REV CYCLE)
Entity Organization
Organization subpart 1 No
Enumeration date 09/20/2012
Last updated 07/07/2023 - About 3 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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