Healthcare Provider Details

I. General information

NPI: 1235753757
Provider Name (Legal Business Name): JEFFREY EDWIN KING JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2020
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 MCCLENNAN BANKS DRIVE MSC 915
CHARLESTON SC
29401
US

IV. Provider business mailing address

PO BOX 23321
NEW YORK NY
10087-4321
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-2300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberMMD.84255
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: