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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 14 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 1457442691 NPPES
Washington Other 605960011 USDLAB
Washington Other 3016KI USDLAB
Washington MEDICAID 8464794 USDLAB
Washington Other 0220796 USDLAB

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