Provider Demographics
NPI:1326472671
Name:KING, JOHN DEE (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DEE
Last Name:KING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6750 PARK RIDGE DR APT A
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-2246
Mailing Address - Country:US
Mailing Address - Phone:563-639-4644
Mailing Address - Fax:
Practice Address - Street 1:329 WEST MIFFLIN ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-5370
Practice Address - Country:US
Practice Address - Phone:608-630-3925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-22
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007676111N00000X
WI4956-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor