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General NPI Number Information
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NPI Number | 1558374041
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Entity Type | Organization
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Legal Business Name | JOHN WESLEY KING, JR.
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 05/21/2020
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Provider Practice Location Address
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Address Line | 641 W THOMAS ST
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City | MILLEDGEVILLE
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State | GA
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Zip | 31061-2337
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Country | US
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Telephone | 478-453-0662
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Fax | 478-452-8067
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Provider Business Mailing Address
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Address Line | 641 W THOMAS ST
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City | MILLEDGEVILLE
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State | GA
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Zip | 31061-2337
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Country | US
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Telephone | 478-453-0662
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Fax | 478-452-8067
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MRS. BOBBIE J MORGAN
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Credential | CPC
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Telephone | 478-453-0662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 207RC0200X
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 207RP1001X
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License Number State | GA
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