GLEN KING (NPI# 1902114960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902114960 |
| Entity Type | Individual |
| Full Name | GLEN KING |
| Practice Address |
Bldg H. 2005 Knight Lane Navy Medicine Support Command Jacksonville FL 32212-0140 |
| Mailing Address |
31 Park Cir Bluffton SC 29910-8011 |
| Practice Telephone | 8432287068 |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2010-09-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902968795 | Glen D King | Psychologist | 1520 Mulberry St, Montgomery, AL 36106-1520 | 2006-12-15 |
| 1750518023 | Glen R King | Family Medicine | 40 Fox Chase, Cartersville, GA 30120-2491 | 2009-06-15 |
| 1558303784 | Glen W. King | Family Medicine | 6151 N Main Street Rd, Webb City, MO 64870-8189 | 2006-06-12 |
| Street Address |
BLDG H. 2005 KNIGHT LANE NAVY MEDICINE SUPPORT COMMAND |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32212-0140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679700652 | Rex Spencer Watson | Student in an Organized Health Care Education/Training Program | Bldg H. 2005 Knight Lane, Navy Medicine Support Command Attn: Mssd, Jacksonville, FL 32212-0140 | 2009-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952911752 | Jeff Woohyeok Chang | Dentist | 964 Ajax Street, Jacksonville, FL 32212 | 2020-08-06 |
| 1518484427 | Amy Kathryn Lee | Student in an Organized Health Care Education/Training Program | Bumed, Centralized Credential & Privileging Directorate, 554 Keily Street, Jacksonville, FL 32212 | 2017-08-23 |
| 1659827970 | Noah Fixelle | Dentist | Bureau of Med and Surg Ccpd, 554 Keily Street, Jacksonville, VA 32212 | 2016-08-28 |
| 1972953339 | Colin Kenneth Kelly | General Practice | Bureau of Medicine & Surgery Detachment, Nas Jacksonville, Building 554, Jacksonville, FL 32212 | 2016-06-16 |
| 1912382359 | Caitlyn Brooke Hoysock | Dentist | 554 Keiley Street, Bureau of Medicine and Surgery - Credentials, Jacksonville, FL 32212 | 2015-07-28 |
| 1285017418 | John Alexander Ruch | Dentist | 554 Keily Street Bureau of Med and Surg Ccpd, Jacksonville, FL 32212 | 2015-07-07 |
| 1407238561 | Amanda Mona Lau | Student in an Organized Health Care Education/Training Program | 554 Kelly Street, Attn Centralized Credentialing, Bureau of Medicine and Surgery, Jacksonville, FL 32212 | 2015-06-25 |
| 1063894715 | Heather Dehaan | Family Medicine | 554 Kelly Street Bureau of Medicine and Surgery, Attention: Centralized Credentialing & Privileging Dire, Jacksonville, FL 32212 | 2015-06-18 |
| 1912389677 | Catherine Garcia | Student in an Organized Health Care Education/Training Program | 554 Kelly St, Credentialing & Privileging Directorate, Bureau of Medicine & Surgery, Attention: Centralized, Jacksonville, FL 32212 | 2015-06-18 |
| 1255712675 | James Robert Benson | Dentist | 734 Keily Street, Bumed, Jacksonville, FL 32212 | 2015-06-11 |
| Find all providers in zip 32212 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639793748 | Johnathon T Brewer | Military Health Care Provider | 100 White St, Jacksonville, NC 28540 | 2020-06-04 |
| 1740803725 | Alanna Gonzalez | Military Health Care Provider | 1453 Lindseys Crossing Dr, Jacksonville, FL 32218-8088 | 2020-05-25 |
| 1538793849 | Alberto Kris Cipollone | Military Health Care Provider | Bon Homme Richard Ave Bldg 2480, Jacksonville, FL 32246-0046 | 2020-02-25 |
| 1376175794 | James Ernest Claypool | Military Health Care Provider | 12411 Glenn Hollow Dr, Jacksonville, FL 32226-2349 | 2020-02-05 |
| 1316584543 | Christina Koch | Military Health Care Provider | 104 Eagle River Ct, Jacksonville, NC 28540-7745 | 2019-12-06 |
| 1174043244 | Jason Waters | Military Health Care Provider | White St, Bldg As-100, Jacksonville, NC 28540 | 2017-06-21 |
| 1023546108 | Gregory Donald Willden | Military Health Care Provider | Bon Homme Richard St, Bldg 2480, Jacksonville, FL 32228 | 2017-06-01 |
| 1285179077 | Bill Lee Todd Davis | Military Health Care Provider | 1151 Murrill Hill Rd, Jacksonville, NC 28540-8662 | 2017-01-03 |
| 1235681545 | Huriel A Rivera Aponte | Military Health Care Provider | Naval Station Mayport, Surflant Medical Readiness Division Detachment Mayport, Jacksonville, FL 32228 | 2016-11-03 |
| 1659727444 | Michael Phoenix Mcfarland | Military Health Care Provider | 898 Enterprise St Unit A, Jacksonville, FL 32227-1202 | 2016-05-11 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32212 |
Please comment or provide details below to improve the information on GLEN KING.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.