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General NPI Number Information
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NPI Number | 1114389764
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Entity Type | Individual
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Provider Name | DR. ROBERT KING
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Gender | Male
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Dates
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Enumeration Date | 03/23/2016
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 2460 S PARKVIEW LOOP STE 3
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City | YUMA
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State | AZ
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Zip | 85364-5357
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Country | US
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Telephone | 928-336-5483
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Fax |
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Provider Business Mailing Address
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Address Line | 2400 S AVENUE A
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City | YUMA
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State | AZ
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Zip | 85364-7127
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Country | US
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Telephone | 928-344-2000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 66962
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License Number State | AZ
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