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General NPI Number Information
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NPI Number | 1144228966
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Entity Type | Individual
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Provider Name | JEFFREY K. KING M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/14/2005
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Last Update Date | 02/01/2012
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Provider Practice Location Address
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Address Line | 3515 RICHMOND CIRCLE
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City | GRAND ISLAND
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State | NE
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Zip | 68803-4965
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Country | US
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Telephone | 308-381-8636
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Fax | 308-381-8622
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Provider Business Mailing Address
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Address Line | 7440 SOUTH 91ST STREET
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City | LINCOLN
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State | NE
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Zip | 68526-9797
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Country | US
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Telephone | 402-489-6555
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Fax | 402-328-3770
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 21858
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 21858
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License Number State | NE
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