Provider Demographics
NPI:1528385366
Name:KING, JEFF H (HIS)
Entity Type:Individual
Prefix:MR
First Name:JEFF
Middle Name:H
Last Name:KING
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 S YALE AVE
Mailing Address - Street 2:CENTENNIAL PLAZA
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74112-6218
Mailing Address - Country:US
Mailing Address - Phone:918-747-6688
Mailing Address - Fax:
Practice Address - Street 1:1901 S YALE AVE
Practice Address - Street 2:CENTENNIAL PLAZA
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74112-6218
Practice Address - Country:US
Practice Address - Phone:918-747-6688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK994237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist