Individual
SAMUEL J. KING II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6435 W JEFFERSON BLVD # 434, FORT WAYNE, IN 46804-6203
(260) 436-7875
(260) 432-9812
Mailing address
PO BOX 843603, DALLAS, TX 75284-0001
(972) 233-1999
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01075535A
IN
207L00000X
Anesthesiology Physician
43519
KY
207L00000X
Anesthesiology Physician
57.014040
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100127110
—
KY
Enumeration date
12/31/2007
Last updated
03/12/2025
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