Individual
MRS. MADELYN B KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2323 5TH ST N, COLUMBUS, MS 39705-2213
(662) 368-1169
(662) 570-1492
Mailing address
2323 5TH ST N, COLUMBUS, MS 39705-2213
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
862819
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03659286
—
MS
Enumeration date
06/29/2006
Last updated
08/28/2019
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