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NPI Code Detail

MEDICARE: JOHN LONNIE KING JR. MD

MEDICARE: JOHN LONNIE KING JR. MD
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
1208600000XSurgery Physician22737OK

General Provider Information

NPI Number : 1467451237
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN LONNIE KING JR. MD
Provider Business Mailing Address
First Line : 6600 S YALE AVE
Second Line : STE 1400
City : TULSA
State : OK
Zip : 74136-3310
Country : US
Telephone Number : 918-488-6001
Fax Number :
Provider Business Practice Location Address
First Line : 6160 S YALE AVE
Second Line :
City : TULSA
State : OK
Zip : 74136-1930
Country : US
Telephone Number : 918-497-3090
Fax Number : 918-495-2633
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2005
Last Update Date : 02/29/2008

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