Individual
MR. MARC C KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2707 BROWNS LN, JONESBORO, AR 72401-7213
(870) 972-4939
(870) 972-4911
Mailing address
703 CALVIN AVERY DR, WEST MEMPHIS, AR 72301-6501
(870) 732-1878
(870) 735-5401
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
LSW0000009067
TN
104100000X
Social Worker
M8249
MS
1041C0700X
Clinical Social Worker
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
770099
AMERICAN PUBLIC LIFE INSURANCE COMPANY
MS
01
—
YAQ 868404380M
BLUECROSS BLUESHIELD
MS
Enumeration date
01/04/2007
Last updated
02/28/2019
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