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General NPI Number Information
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NPI Number | 1649682667
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Entity Type | Individual
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Provider Name | JAMES KING M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/26/2014
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Last Update Date | 04/08/2020
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Provider Practice Location Address
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Address Line | 4540 S SOMMERSET DR
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City | NEW BERLIN
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State | WI
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Zip | 53151-6876
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Country | US
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Telephone | 414-422-8606
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Fax | 480-262-5476
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Provider Business Mailing Address
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Address Line | 4540 S SOMMERSET DR
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City | NEW BERLIN
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State | WI
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Zip | 53151-6876
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Country | US
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Telephone | 414-422-8606
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Fax | 480-262-5476
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 18387-020
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License Number State | WI
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