Provider Demographics
NPI:1255710117
Name:KING, JASON (MD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:KING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:226 SE DEBELL AVE STE B
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-2300
Mailing Address - Country:US
Mailing Address - Phone:918-331-1060
Mailing Address - Fax:918-331-1065
Practice Address - Street 1:226 SE DEBELL AVE STE B
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-2300
Practice Address - Country:US
Practice Address - Phone:918-331-1060
Practice Address - Fax:918-331-1065
Is Sole Proprietor?:No
Enumeration Date:2015-05-26
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK313752084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology