Organization
JONATHAN S KING MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN S KING M.D. (PHYSICIAN)
(208) 667-7459
Entity
Organization
Contact information
Practice address
1107 W IRONWOOD DR, COEUR D ALENE, ID 83814-2604
(208) 667-7459
(208) 667-2631
Mailing address
1107 W IRONWOOD DR, COEUR D ALENE, ID 83814-2604
(208) 667-7459
(208) 667-2631
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
M9264
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807235300
—
ID
01
—
P00331085
RAILROAD MEDICARE
ID
Enumeration date
08/15/2006
Last updated
08/27/2014
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