King, Timothy Earl

King, Timothy Earl is an individual health care provider with primary practice located at 11456 Broadway , Crown Point IN 46307-7106. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is his primary health care specialty. King, Timothy Earl can be contacted via phone (219) 488-0154.

Contact Information

Primary practice address
11456 Broadway Crown Point IN 46307-7106
Phone: (219) 488-0154
Fax: (219) 661-1408
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X 036097585 Illinois
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X 01025676A Indiana
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X 01025676A Indiana

Profile Details

NPI number 1215963202
LBN Legal business name King, Timothy Earl
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2006
Last updated Nov 11th, 2015 - about 9 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 1215963202 NPPES
Indiana MEDICAID 100113830B

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