| Doctor Name: | MR. JOHNNY KING |
| NPI Number: | 1053543348 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RN, BSN, MPH, BC-APH |
| License Number: | RN087034 |
| Business Practice Address: | 1061 Harmon Avenue Ste 1d03 Fort Stewart, GA - 313145674 |
| Business Phone Number: | 9124355071 |
| Business Fax Number: | |
| Mailing Address: | 1061 Harmon Avenue, Ste 1d03 FORT STEWART |
| State: | GA |
| Postal Code: | 313145674 |
| Phone Number: | 9124355071 |
| Fax Number: | |
| NPI Enumeration Date: | 08/20/2009 |
| NPI Last Update Date: | 09/01/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC1500X |
| License Number: | RN087034 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |