King, Glen W.

King, Glen W. is an individual health care provider with primary practice located at 6151 N Main Street Rd , Webb City MO 64870-8189. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. King, Glen W. can be contacted via phone (417) 781-0408.

Contact Information

Primary practice address
6151 N Main Street Rd Webb City MO 64870-8189
Phone: (417) 781-0408
Fax: (417) 556-5377
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 113228 Missouri

Profile Details

NPI number 1558303784
LBN Legal business name King, Glen W.
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2006
Last updated Apr 6th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558303784 NPPES
Missouri Other P00817803 RAIL ROAD MEDICARE
Missouri MEDICAID 200090170A RAIL ROAD MEDICARE
Missouri MEDICAID 1558303784 RAIL ROAD MEDICARE

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