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NPI Code Detail

MEDICARE: MATTHEW JAY KING

MEDICARE: MATTHEW JAY KING
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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1811529191
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW JAY KING
Provider Business Mailing Address
First Line : 5604 WHITEFORD RD
Second Line :
City : SYLVANIA
State : OH
Zip : 43560-2526
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5151 MONROE ST STE 204
Second Line :
City : TOLEDO
State : OH
Zip : 43623-3467
Country : US
Telephone Number : 419-865-5690
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2020
Last Update Date : 02/05/2020

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Directions to “ MATTHEW JAY KING ” Practice Location

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