Individual
KALEB KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1501 E 19TH ST, EDMOND, OK 73013-6618
(405) 348-6611
(405) 348-9280
Mailing address
1501 E 19TH ST, EDMOND, OK 73013-6618
(405) 348-6611
(405) 348-9280
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
41812
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/08/2020
Last updated
09/07/2023
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