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NPI Code Detail

MEDICARE: GREGORY J KING APRN

MEDICARE: GREGORY J KING APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner44801KS

General Provider Information

NPI Number : 1255423364
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGORY J KING APRN
Provider Business Mailing Address
First Line : PO BOX 3810
Second Line :
City : JOPLIN
State : MO
Zip : 64803-3810
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2322 S MAIN ST
Second Line :
City : FORT SCOTT
State : KS
Zip : 66701-3026
Country : US
Telephone Number : 620-223-8064
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2006
Last Update Date : 05/02/2023

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