Individual
DR. MATTHEW STEPHEN KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
761 BOSTON POST RD, OLD SAYBROOK, CT 06475-2126
(860) 388-9300
(860) 395-2885
Mailing address
1 CARDINAL RD, EAST LYME, CT 06333-1044
(860) 739-7191
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
CT2644
CT
152W00000X
Optometrist
OPT 12593T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020644
CONNECTICARE
CT
01
—
090002644CT01
ANTHEM
CT
01
—
2V6356
HEALTHNET
CT
01
—
3539787
AETNA
CT
01
—
P00099397
RAILROAD MEDICARE
CT
Enumeration date
07/17/2006
Last updated
07/08/2007
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