Healthcare Provider Details

I. General information

NPI: 1407035447
Provider Name (Legal Business Name): STEVEN D. KING, D.O., P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2007
Last Update Date: 10/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 E 15TH ST STE 400B
EDMOND OK
73013-5040
US

IV. Provider business mailing address

PO BOX 25943
OKLAHOMA CITY OK
73125-0943
US

V. Phone/Fax

Practice location:
  • Phone: 405-340-2600
  • Fax:
Mailing address:
  • Phone: 405-329-3149
  • Fax: 405-329-2987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number3770
License Number StateOK

VIII. Authorized Official

Name: DR. STEVEN D. KING
Title or Position: OWNER
Credential: D.O.
Phone: 405-340-2600