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General NPI Number Information
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NPI Number | 1558591073
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Entity Type | Individual
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Provider Name | JENNIFER KING MD
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Gender | Female
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Dates
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Enumeration Date | 07/17/2009
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Last Update Date | 06/08/2012
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Provider Practice Location Address
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Address Line | 684 HARVEY ST SUITE 201
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City | MUSKEGON
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State | MI
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Zip | 49442-4274
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Country | US
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Telephone | 231-777-2732
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Fax | 231-773-8979
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Provider Business Mailing Address
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Address Line | 684 HARVEY ST SUITE 201
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City | MUSKEGON
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State | MI
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Zip | 49442-4274
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Country | US
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Telephone | 231-777-2732
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Fax | 231-773-8979
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 4301094909
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License Number State | MI
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