Individual
MR. MICHAEL DON KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
188 W OXFORD ST, PONTOTOC, MS 38863-2006
(662) 983-0139
(662) 796-3190
Mailing address
PO BOX 981, OXFORD, MS 38655-0981
(662) 983-0139
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
R654388
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06707899
—
MS
Enumeration date
03/15/2010
Last updated
01/18/2018
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