=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457427817
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | VALTON N KING D.O.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/28/2006
-----------------------------------------------------
Last Update Date | 12/22/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 839 E 1200 S
-----------------------------------------------------
City | OREM
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84097-6603
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-224-0891
-----------------------------------------------------
Fax | 801-224-7100
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 970188
-----------------------------------------------------
City | OREM
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84097-0188
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-377-5467
-----------------------------------------------------
Fax | 801-224-7100
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208100000X
-----------------------------------------------------
Taxonomy Name | Physical Medicine & Rehabilitation Physician
-----------------------------------------------------
License Number | 91-180362-1204
-----------------------------------------------------
License Number State | UT
-----------------------------------------------------