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Individual

JOHN C KING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4608 HIGHWAY 1, SUITE 230, RACELAND, LA 70394-2623
(985) 446-5210
(985) 446-8327
Mailing address
1545 HIGHWAY 654, GHEENS, LA 70355-2103
(985) 446-5210
(985) 446-8327

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD 08070R
LA
207R00000X
Internal Medicine Physician
Primary
08070R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1900G5312Z
BC OF LA
LA
05
1939293
LA
01
290004895
RAILROAD MEDICARE
LA
Enumeration date
06/08/2006
Last updated
02/24/2011
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