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General NPI Number Information
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NPI Number | 1861567406
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Entity Type | Individual
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Provider Name | PROF. SARA MARIE KING
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Gender | Female
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4122 E TOWNE BLVD
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City | MADISON
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State | WI
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Zip | 53704-3732
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Country | US
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Telephone | 608-242-6862
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Fax | 608-245-6125
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Provider Business Mailing Address
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Address Line | 4705 DUSTIN LN
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City | MADISON
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State | WI
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Zip | 53718-4319
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Country | US
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Telephone | 608-838-6746
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 13119-040
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License Number State | WI
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