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General NPI Number Information
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NPI Number | 1255423364
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Entity Type | Individual
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Provider Name | GREGORY J KING APRN
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Gender | Male
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 05/02/2023
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Provider Practice Location Address
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Address Line | 2322 S MAIN ST
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City | FORT SCOTT
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State | KS
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Zip | 66701-3026
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Country | US
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Telephone | 620-223-8064
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3810
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City | JOPLIN
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State | MO
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Zip | 64803-3810
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Country | US
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Telephone |
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 44801
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License Number State | KS
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