King, Everett Lyle

King, Everett Lyle is an individual health care provider with primary practice located at 418 S 5Th St , Laramie WY 82070-3733. He recently has only one registered license in Eye and Vision Services Providers / Corneal and Contact Management, which is considered as his primary health care specialty. King, Everett Lyle can be contacted via phone (307) 745-8554.

Contact Information

Primary practice address
418 S 5Th St Laramie WY 82070-3733
Phone: (307) 745-8554
Fax: (307) 755-5929
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X WYOMING 143T Wyoming

Profile Details

NPI number 1699751024
LBN Legal business name King, Everett Lyle
Credentials O.D., F.A.A.O.
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 18th, 2005
Last updated May 15th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699751024 NPPES
Wyoming MEDICAID 104080400
Wyoming Other 83-0324373

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