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NPI Code Detail

MEDICARE: BRYANT ALAN KING M.D.

MEDICARE: BRYANT ALAN KING M.D.
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
1207RN0300XNephrology Physician01061402AIN
2207R00000XInternal Medicine Physician01061402AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720010341
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYANT ALAN KING M.D.
Provider Business Mailing Address
First Line : 3436 KENILWORTH DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46228-2703
Country : US
Telephone Number : 317-757-9731
Fax Number : 317-291-0640
Provider Business Practice Location Address
First Line : 3436 KENILWORTH DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46228-2703
Country : US
Telephone Number : 317-757-9731
Fax Number : 317-291-0640
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2006
Last Update Date : 08/12/2019

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