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Individual
DR. KENNETH WILLIAM KING JR.
Active
Individual
DR. KENNETH WILLIAM KING JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
ODP0467
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002543100
—
ID
01
—
0605250001
DMERC
—
01
—
82052
BLUE SHIELD
ID
01
—
I-902428
CHAMPUS
—
Enumeration date
08/04/2005
Last updated
12/20/2013
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