Provider Demographics
NPI:1225183601
Name:KING, HARRY R (OD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:R
Last Name:KING
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3505 W KENOSHA ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-8948
Mailing Address - Country:US
Mailing Address - Phone:918-663-2020
Mailing Address - Fax:918-663-2064
Practice Address - Street 1:3505 W KENOSHA ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-8948
Practice Address - Country:US
Practice Address - Phone:918-872-6161
Practice Address - Fax:918-872-6164
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2339152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist