King, Scott J

King, Scott J is an individual health care provider with primary practice located at 611 E Douglas Rd Ste 200 , Mishawaka IN 46545-1465. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. King, Scott J can be contacted via phone (574) 272-5347.

Contact Information

Primary practice address
611 E Douglas Rd Ste 200 Mishawaka IN 46545-1465
Phone: (574) 272-5347
Fax: (574) 272-8617
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 01070924A Indiana
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 01070924A Indiana

Profile Details

NPI number 1477765071
LBN Legal business name King, Scott J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 4th, 2007
Last updated Sep 15th, 2020 - about 4 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 1477765071 NPPES
Indiana MEDICAID 201072620

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