Provider Demographics
NPI:1225090558
Name:KING, STEVEN DUANE (DO)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:DUANE
Last Name:KING
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:4401 W MEMORIAL RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-1785
Mailing Address - Country:US
Mailing Address - Phone:405-752-3162
Mailing Address - Fax:405-936-5211
Practice Address - Street 1:501 E 15TH ST
Practice Address - Street 2:SUITE 400-B
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-5043
Practice Address - Country:US
Practice Address - Phone:405-340-2600
Practice Address - Fax:405-285-1727
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2014-05-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK3770207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK248524902Medicare ID - Type Unspecified
OKH25452Medicare UPIN