Individual
JEREMY S KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
511 HEROD DR, WINONA, MS 38967-1509
(662) 417-6272
Mailing address
511 HEROD DR, WINONA, MS 38967-1509
(662) 417-6272
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
MRT-6515
MS
Other
Enumeration date
09/27/2023
Last updated
09/27/2023
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