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Individual

MARK KING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
205 BYRAM PKWY, BYRAM, MS 39272-9609
(601) 362-5349
Mailing address
958 BULLRUN DR, BYRAM, MS 39272-4445
(769) 972-1843

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P296731
MS

Other

Enumeration date
07/29/2021
Last updated
07/29/2021
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