King, Michael Shane

King, Michael Shane is an individual health care provider with primary practice located at 2510 Lakeland Dr , Flowood MS 39232-9513. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. King, Michael Shane can be contacted via phone (601) 355-1234.

Contact Information

Primary practice address
2510 Lakeland Dr Flowood MS 39232-9513
Phone: (601) 355-1234
Fax: (601) 326-3559
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X R850443 Mississippi

Profile Details

NPI number 1992861298
LBN Legal business name King, Michael Shane
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 29th, 2006
Last updated Nov 2nd, 2017 - about 7 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 1992861298 NPPES
Mississippi MEDICAID 06082519
Mississippi Other P01073766

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