Individual
DR. KELLY KING
Active
Individual
DR. KELLY KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
37446
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020625894
FEDERAL TAX ID
CO
Enumeration date
09/20/2006
Last updated
10/31/2012
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