King, Mark E
King, Mark E is an individual health care provider with primary practice located at 1401 Sudderth Dr , Ruidoso NM 88345-6104. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. King, Mark E can be contacted via phone (575) 257-7712.Contact Information
Primary practice address
1401 Sudderth Dr
Ruidoso NM 88345-6104
Phone: (575) 257-7712
Fax: (575) 257-4513
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 10003262 | Washington |
Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 95-PA19 | New Mexico |
Profile Details
NPI number | 1457442691 |
---|---|
LBN Legal business name | King, Mark E |
Credentials | Physician Assistant (PA) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Sep 27th, 2006 |
Last updated | Apr 3rd, 2012 - about 13 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1457442691 | NPPES |
Washington | Other | 605960011 | USDLAB |
Washington | Other | 3016KI | USDLAB |
Washington | MEDICAID | 8464794 | USDLAB |
Washington | Other | 0220796 | USDLAB |
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