Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 12495 | OK |
N | 2084N0400X | Neurologist | 13879R | LA |
NPI | 1033239629 |
---|---|
Provider Name | Dr. Jeanne Ann Freeman King |
First Address | Oklahoma City, OK 73104-5021 |
Second Address | Oklahoma City, OK 73104-5023 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2007 |
Last Update Date | 11/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100824980E | (05) | OK |