Individual
DR. KENNETH KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3625 UNIVERSITY BLVD S, EMERGENCY DEPARTMENT, JACKSONVILLE, FL 32216-4207
(904) 346-3606
(904) 346-0113
Mailing address
PO BOX 860554, ORLANDO, FL 32886-0554
(904) 346-3606
(904) 346-0113
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
OS0008648
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13735
BCBS
FL
Enumeration date
01/05/2006
Last updated
07/23/2007
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