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General NPI Number Information
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NPI Number | 1427472307
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Entity Type | Organization
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Legal Business Name | INTEGRAMED MEDICAL - KING, LLC
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Dates
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Enumeration Date | 02/12/2014
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Last Update Date | 03/27/2014
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Provider Practice Location Address
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Address Line | 5320 S RAINBOW BLVD SUITE 300
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City | LAS VEGAS
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State | NV
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Zip | 89118-1895
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Country | US
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Telephone | 702-892-9696
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Fax |
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Provider Business Mailing Address
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Address Line | 5320 S RAINBOW BLVD SUITE 300
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City | LAS VEGAS
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State | NV
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Zip | 89118-1895
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Country | US
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Telephone | 702-892-9696
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND SECRETARY
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Name | JAMES T KING
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Credential |
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Telephone | 702-892-9696
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number |
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License Number State | NV
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