Individual
MICHAEL TYLER KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3600 W BETHEL AVE, MUNCIE, IN 47304-5407
(800) 622-6575
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01077058A
IN
207L00000X
Anesthesiology Physician
A126418
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001566618
ANTHEM PTAN
IN
01
—
1102510166
ANTHEM PTAN
IN
05
—
201386470
—
IN
Enumeration date
03/30/2012
Last updated
01/07/2025
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