# KING'S COURT FAMILY MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235468745
- **Authorized official:** AMY TALLEY (ASSISTANT MANAGER)
- **Authorized official phone:** (918) 322-0099

## Contact information

- **Practice address:** 9222 S ELWOOD AVE STE C, JENKS, OK 74037-2369
- **Practice address phone:** (918) 322-0099
- **Practice address fax:** (918) 925-9966
- **Mailing address:** 9222 S ELWOOD AVE STE C, JENKS, OK 74037-2369
- **Mailing address phone:** (918) 322-0099
- **Mailing address fax:** (918) 925-9966

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 4427 | OK | Yes |

## Other

- **Enumeration date:** 12/11/2009
- **Last updated:** 07/27/2021