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General NPI Number Information
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NPI Number | 1306039276
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Entity Type | Individual
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Provider Name | DAVID MICHAEL KING D.O.
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Gender | Male
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Dates
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Enumeration Date | 08/23/2007
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Last Update Date | 08/19/2024
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Provider Practice Location Address
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Address Line | 1010 SPRUCE ST
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City | ESPANOLA
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State | NM
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Zip | 87532-2724
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Country | US
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Telephone | 505-367-0346
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 26666 PHS PROVIDER ENROLLMENT
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City | ALBUQUERQUE
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State | NM
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Zip | 87125-6666
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Country | US
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Telephone | 918-906-8262
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A-2098-17
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License Number State | NM
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