Healthcare Provider Details

I. General information

NPI: 1174456198
Provider Name (Legal Business Name): JOSHUA ALEXANDER KING
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

568 POPLAR AVE
MEMPHIS TN
38105-4510
US

IV. Provider business mailing address

8315 REMBROOK DR
CORDOVA TN
38016-4569
US

V. Phone/Fax

Practice location:
  • Phone: 901-704-7899
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number269446
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: