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General NPI Number Information
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NPI Number | 1871160580
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Entity Type | Individual
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Provider Name | PRESTON N KING DNP, CRNA.
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Gender | Male
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Dates
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Enumeration Date | 06/10/2021
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 117 E 19TH ST
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City | ROSWELL
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State | NM
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Zip | 88201-5151
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Country | US
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Telephone | 575-627-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 514 AMERICAS WAY PMB # 23255
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City | BOX ELDER
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State | SD
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Zip | 57719-7600
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Country | US
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Telephone | 573-429-1313
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 64064
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 207LP3000X
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Taxonomy Name | Pediatric Anesthesiology Physician
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License Number | 64064
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 64064
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License Number State | NM
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