Jerry D. King, O.D. – Optometrist in Eldon, MO

Key facts

NPI: 1295913283
Entity type: Organization (NPI type 2)
Primary specialty: Optometrist 152W00000X
Legal business name: JERRY D. KING, O.D.
Practice address: 115 N Oak St
Eldon, MO 65026-1444
Phone: (573) 392-7126
NPI assigned: Feb 1, 2008
Organization subpart: No

Authorized official

Name: Dr. Jerry D. King, O.D.
Title: Sole Proprietor
Phone: (573) 392-7126

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Optometrist Group: 193400000X SINGLE SPECIALTY GROUP	152W00000X			Yes
Durable Medical Equipment & Medical Supplies	332B00000X

Addresses

Primary practice location

115 N Oak St
Eldon, MO 65026-1444

Mailing address

115 N Oak St
Eldon, MO 65026-1444
Phone (573) 392-7126

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 1, 2008.

{
    "created_epoch": "1201824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201824000000",
    "number": "1295913283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 N OAK ST",
            "city": "ELDON",
            "state": "MO",
            "postal_code": "650261444",
            "telephone_number": "573-392-7126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 N OAK ST",
            "city": "ELDON",
            "state": "MO",
            "postal_code": "650261444",
            "telephone_number": "573-392-7126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY D. KING, O.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-01",
        "last_updated": "2008-02-01",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "573-392-7126",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eldon, MO

All providers in Eldon, MO · Optometrist in Missouri

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2008. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.