Provider Demographics
NPI:1932267812
Name:MAJ JOHN D. KING
Entity Type:Organization
Organization Name:MAJ JOHN D. KING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALS PROGRAM MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:PIERRE
Authorized Official - Middle Name:L
Authorized Official - Last Name:SWAFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:01149931-804-2457
Mailing Address - Street 1:USAMEDDAC WUERZBURG UNIT 26610
Mailing Address - Street 2:ATTN CREDENTIALS OFFICE
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09244
Mailing Address - Country:US
Mailing Address - Phone:01149931-804-3616
Mailing Address - Fax:01149931-804-3241
Practice Address - Street 1:USAMEDDAC WUERZBURG, UNIT 26610
Practice Address - Street 2:US ARMHY HEALTH CLINIC, WUERZBURG
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09244
Practice Address - Country:US
Practice Address - Phone:01149931-804-3616
Practice Address - Fax:01149931-804-3241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA431015286500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN