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General NPI Number Information
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NPI Number | 1497230015
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Entity Type | Individual
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Provider Name | ANDREA KING
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Gender | Female
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Dates
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Enumeration Date | 09/28/2018
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Last Update Date | 09/28/2018
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Provider Practice Location Address
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Address Line | 12631 E 17TH AVE
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City | AURORA
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State | CO
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Zip | 80045-2527
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Country | US
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Telephone | 303-724-2972
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Fax |
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Provider Business Mailing Address
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Address Line | 5657 S RIFLE CT
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City | CENTENNIAL
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State | CO
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Zip | 80015-3051
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Country | US
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Telephone | 303-550-4316
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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 | 207XX0801X
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Taxonomy Name | Orthopaedic Trauma Physician
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License Number | PA.0005539
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License Number State | CO
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