Individual
PATRICK HOLT KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
1389
SD
207W00000X
Ophthalmology Physician
17531
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0009384
SD WELLMARK BLUE SHIELD
SD
01
—
1389
DAKOTACARE PROVIDER ID
—
01
—
22052
NE BLUE SHIELD ID
NE
05
—
36-3050195-13
—
SD
05
—
36-3050195-14
—
NE
05
—
6300280
—
SD
01
—
NA1114003
MEDICARE PTAN NORFOLK, NE
NE
01
—
NA1115003
NE MEDICARE PTAN O'NEILL, NE
NE
Enumeration date
05/24/2005
Last updated
11/04/2008
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