Individual
JEREMIAH ROGERS KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3286 OAK ST, WISNER, LA 71378
(318) 724-6789
(318) 724-6788
Mailing address
PO BOX 899, COLUMBIA, LA 71418-0899
(318) 649-6111
(318) 649-5094
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
203957
LA
Other
Enumeration date
03/04/2019
Last updated
03/04/2019
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