Provider Demographics
NPI:1255350021
Name:KING, JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:KING
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9800 BAPTIST HEALTH DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6243
Mailing Address - Country:US
Mailing Address - Phone:501-219-0900
Mailing Address - Fax:501-312-4750
Practice Address - Street 1:9800 BAPTIST HEALTH DR STE 200
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6243
Practice Address - Country:US
Practice Address - Phone:501-219-0900
Practice Address - Fax:501-312-4750
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2019-04-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARE8699207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR205037001Medicaid