Provider Demographics
NPI:1255338083
Name:KING, MARY J (DO)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:J
Last Name:KING
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Gender:F
Credentials:DO
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Mailing Address - Street 1:8130 66TH ST N
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-2111
Mailing Address - Country:US
Mailing Address - Phone:727-592-4994
Mailing Address - Fax:727-317-4999
Practice Address - Street 1:8130 66TH ST N
Practice Address - Street 2:SUITE 1
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-2111
Practice Address - Country:US
Practice Address - Phone:727-592-4994
Practice Address - Fax:727-317-4999
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2016-05-19
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Provider Licenses
StateLicense IDTaxonomies
FLOS0007369207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine