DR. BRADLEY OWEN KING (NPI# 1639118367) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639118367 |
| Entity Type | Individual |
| Full Name | DR. BRADLEY OWEN KING |
| Credential | MD |
| Practice Address |
1000 S Beckham Ave Tyler TX 75701-1908 |
| Practice Telephone | 9035970351 |
| Practice Fax Number | 9035259301 |
| Mailing Telephone | 9035970351 |
| Mailing Fax Number | 9035259301 |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2014-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | L0336 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 0372286-04 | 05 | |
| TX | RAILROAD MEDICARE | 930120767 | 01 |
| TX | BLUE CROSS | 8F6462 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881150035 | Bradley King | Student in an Organized Health Care Education/Training Program | 10600 Steamboat Lndg, Columbia, MD 21044-4149 | 2019-02-13 |
| 1285960955 | Bradley King | Registered Nurse | 203 Peebles Ave, Franklin, KY 42134-1637 | 2009-10-30 |
| 1174633036 | Bradley Edholm King | Dentist | 121 E Front Ave, Bismarck, ND 58504-5589 | 2006-08-30 |
| 1205464732 | Bradley King | Student in an Organized Health Care Education/Training Program | 201 State St, Erie, PA 16550-0002 | 2020-03-30 |
| 1790298289 | Bradley Stephen King | Counselor | 221 E Washington Ave, Dayton, WA 99328-1317 | 2017-11-07 |
| 1215357033 | Bradley Anthony King | Orthopaedic Surgery | 3301 Mercy Health Blvd Ste 450, Cincinnati, OH 45211-1106 | 2014-04-19 |
| 1689014904 | Bradley King | Case Manager/Care Coordinator | 204 Frankie Ln, White Hall, AR 71602-2699 | 2013-07-01 |
| 1043504152 | Bradley Mark King | Ophthalmology | 1016 Kirkpatrick Rd, Burlington, NC 27215-9714 | 2011-06-06 |
| 1336453240 | Bradley Stephen King | Pharmacist | 220 S Main St, Stanley, NC 28164-2011 | 2010-08-03 |
| 1295948206 | Bradley King | Radiology | 12368 Stratford Dr, Suite 300, Clive, IA 50325-8162 | 2007-05-07 |
| Street Address |
1000 S BECKHAM AVE |
| City | TYLER |
| State | TX |
| Zip Code | 75701-1908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740280510 | Aleksandra Olsson-detwiler | Internal Medicine | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2005-07-22 |
| 1831706431 | Kalana Sanders | Registered Nurse | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2020-09-28 |
| 1992333975 | Graceanne M. Dimon | Physical Therapist | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2020-03-27 |
| 1760021976 | Gerardo Tapia Hernandez | Nurse Practitioner | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2020-01-06 |
| 1861950057 | Brittany Mason Ferguson | Nurse Practitioner | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2019-03-06 |
| 1255801189 | Shane Ashley Correa | Nurse Practitioner | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2018-12-04 |
| 1174000962 | David Matthew Burkland | Nurse Practitioner | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2018-07-24 |
| 1598251209 | Kelsey Rene Morton | Nurse Practitioner | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2018-07-05 |
| 1063915916 | Tyler Regional Hospital LLC | Surgery | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2018-03-16 |
| 1437650264 | Tyler Regional Hospital LLC | Nurse Anesthetist, Certified Registered | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2018-02-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962057059 | Gonzalo Fernandez | Physical Therapy Assistant | 753 S Beckham Ave, Tyler, TX 75701 | 2019-08-06 |
| 1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
| 1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
| 1992208912 | Heather Renee Vancleave | Occupational Therapy Assistant | 1228 Louann Lane, Tyler, TX 75701 | 2018-03-15 |
| 1497260533 | Smile Workshop Mckinney, Pllc | Dentist | 301 N. Custer Rd, Mckinney, TX 75701 | 2017-12-12 |
| 1396266441 | Eye Surgery Center of East Texas, Pllc | Clinic/Center | 2448 E 5th St, Tyler, TX 75701 | 2017-06-29 |
| 1962936369 | Collins Complete Family Care | Nurse Practitioner | 1910 E Se Loop 323 # 176, Tyler, TX 75701 | 2017-04-12 |
| 1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
| 1205382454 | Brenton Robinson | Nurse Practitioner | 1100 East Lake St, 160, Tyler, TX 75701 | 2016-08-28 |
| 1851846208 | Care First Pharmacy, LLC | Pharmacy | 1910 Roseland Blvd A, Tyler, TX 75701 | 2016-08-15 |
| Find all providers in zip 75701 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407140106 | Mark W Mcdonald | Emergency Medicine | 629 Winding Brook Ln, Tyler, TX 75703-0832 | 2011-05-31 |
| 1235260084 | Michael Byron Taylor | Emergency Medicine | 3102 Lakepine Cir, Tyler, TX 75707-1724 | 2007-03-07 |
| 1346279031 | Jill Marie Wortham | Emergency Medicine | 6210 S. Broadway, Tyler, TX 75703 | 2006-07-03 |
| 1699719872 | East Texas Medical Center Healthcare Associates | Emergency Medicine | 1000 S Beckham, Tyler, TX 75701 | 2006-06-16 |
| 1326082892 | East Texas Medical Center Healthcare Associates | Emergency Medicine | 6210 S Broadway Ave, Tyler, TX 75703-4413 | 2006-06-15 |
| 1760425326 | Bradley Robertson | Emergency Medicine | 1809 Capital Dr, Tyler, TX 75701-8438 | 2006-06-13 |
| 1902849417 | Mack D Stewart | Emergency Medicine | 107 Robert E Lee Dr, Tyler, TX 75703-4602 | 2006-06-13 |
| 1295782977 | Sergio V Figueroa Jr. | Emergency Medicine | 1436 Hollytree Pl, Tyler, TX 75703-5774 | 2006-05-28 |
| 1144209354 | Paula Alinda Bessonett | Emergency Medicine | 222 E. Fifth Street, Tyler, TX 75701 | 2006-01-16 |
| 1871578989 | Evans Swann Smith | Emergency Medicine | 833 S Beckham Ave, Tyler, TX 75701-1905 | 2005-12-12 |
| Find all providers in TYLER | ||||
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| 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.