Individual
MS. MARY ADELE KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1400 E DOWNING ST, TAHLEQUAH, OK 74464-3324
(918) 456-0641
Mailing address
908 N OKLAHOMA AVE, TAHLEQUAH, OK 74464-7122
(918) 456-9221
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
1833
OK
Other
Enumeration date
10/06/2006
Last updated
07/09/2007
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