Healthcare Provider Details

I. General information

NPI: 1811622392
Provider Name (Legal Business Name): JAMES K KING
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2022
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2865 DAGGETT AVE
KLAMATH FALLS OR
97601-1106
US

IV. Provider business mailing address

2995 FM 316
MABANK TX
75147-4532
US

V. Phone/Fax

Practice location:
  • Phone: 541-882-6311
  • Fax:
Mailing address:
  • Phone: 903-343-9710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number227281
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number324800
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1095999
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number10027429
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: