Provider Demographics
NPI:1023301876
Name:KING, BRYAN JENKINS (MD)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:JENKINS
Last Name:KING
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3170 KETTERING BLVD BLDG B3
Mailing Address - Street 2:
Mailing Address - City:MORAINE
Mailing Address - State:OH
Mailing Address - Zip Code:45439-1924
Mailing Address - Country:US
Mailing Address - Phone:937-991-3188
Mailing Address - Fax:937-223-9811
Practice Address - Street 1:3006 N COUNTY ROAD 25A STE 104
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-1373
Practice Address - Country:US
Practice Address - Phone:937-335-3518
Practice Address - Fax:937-332-6857
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35.132218207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease