Provider Demographics
NPI:1740269992
Name:KING, RAY (PSYD)
Entity type:Individual
Prefix:DR
First Name:RAY
Middle Name:
Last Name:KING
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:DR
Other - First Name:RAYMOND
Other - Middle Name:ELLIOTT
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:3812 BUCKINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-1753
Mailing Address - Country:US
Mailing Address - Phone:405-408-5216
Mailing Address - Fax:405-954-4852
Practice Address - Street 1:5700 ARNOLD ST
Practice Address - Street 2:72MDG/SGOH (LSSC)
Practice Address - City:TINKER AFB
Practice Address - State:OK
Practice Address - Zip Code:73145-8105
Practice Address - Country:US
Practice Address - Phone:405-408-5216
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical