MEDICARE: THOMAS IGNATIUS KING DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	TK001638	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578586780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS IGNATIUS KING DPM

Provider Business Mailing Address
First Line	:	1431 E 12 MILE RD
Second Line	:
City	:	MADISON HEIGHTS
State	:	MI
Zip	:	48071-2653
Country	:	US
Telephone Number	:	248-542-5372
Fax Number	:	248-398-4345

Provider Business Practice Location Address
First Line	:	1431 E 12 MILE RD
Second Line	:
City	:	MADISON HEIGHTS
State	:	MI
Zip	:	48071-2653
Country	:	US
Telephone Number	:	248-542-5372
Fax Number	:	248-398-4345

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	01/27/2017

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