Provider Demographics
NPI:1730526328
Name:KING, KRISTIN DELANEY (MD)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:DELANEY
Last Name:KING
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1145 S UTICA AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-4013
Mailing Address - Country:US
Mailing Address - Phone:918-579-1858
Mailing Address - Fax:918-579-3760
Practice Address - Street 1:6802 S OLYMPIA AVE STE 301
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74132-1823
Practice Address - Country:US
Practice Address - Phone:918-560-3823
Practice Address - Fax:918-579-5782
Is Sole Proprietor?:No
Enumeration Date:2013-05-23
Last Update Date:2024-10-08
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Provider Licenses
StateLicense IDTaxonomies
OK337482084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO04-21-1987OtherDATE OF BIRTH
MO2013020318OtherMISSOURI TEMP ID NUMBER