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General NPI Number Information
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NPI Number | 1598804130
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Entity Type | Organization
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Legal Business Name | DESERT MOUNTAIN ORTHOPAEDIC & SPORTS MEDICINE
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1301 BERTHA HOWE AVE 11
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City | MESQUITE
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State | NV
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Zip | 89027-7502
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Country | US
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Telephone | 702-345-2600
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Fax | 702-345-2603
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Provider Business Mailing Address
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Address Line | 1301 BERTHA HOWE AVE 11
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City | MESQUITE
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State | NV
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Zip | 89027-7502
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Country | US
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Telephone | 702-345-2600
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Fax | 702-345-2603
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Authorized Official
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Title or Position | DOCTOR,OWNER
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Name | DR. DAVID C KING
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Credential | M.D.
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Telephone | 702-345-2600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 11095
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License Number State | NV
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