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General NPI Number Information
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NPI Number | 1710126156
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Entity Type | Organization
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Legal Business Name | THOMAS I KING DPM PC
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Dates
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Enumeration Date | 02/09/2009
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Last Update Date | 03/04/2009
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Provider Practice Location Address
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Address Line | 1431 EAST TWELVE MILE RD BUILLDING C
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City | MADISON HEIGHTS
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State | MI
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Zip | 48071
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Country | US
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Telephone | 248-542-5374
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Fax | 248-398-4345
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Provider Business Mailing Address
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Address Line | 1431 EAST TWELVE MILE RD BUILLDING C
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City | MADISON HEIGHTS
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State | MI
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Zip | 48071
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Country | US
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Telephone | 248-542-5374
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Fax | 248-398-4345
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Authorized Official
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Title or Position | PHYSICIAN
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Name | THOMAS I KING
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Credential | DPM
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Telephone | 248-542-7354
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | TK001638
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License Number State | MI
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