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Individual

PATRICK HOLT KING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
415 W 3RD ST, YANKTON, SD 57078-4201
(605) 665-9638
(605) 665-0526
Mailing address
PO BOX 819, YANKTON, SD 57078-0819
(605) 665-9638
(605) 665-0526

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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