Individual
BENJAMIN RICHARD KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1515 E 20TH ST, FARMINGTON, NM 87401-9039
(505) 326-6400
(505) 326-4606
Mailing address
801 W MAPLE ST, FARMINGTON, NM 87401-5630
(505) 609-2000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA-01133
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07957866
—
NM
05
—
1588962419
—
UT
05
—
601683
—
AZ
05
—
82373370
—
CO
Enumeration date
03/01/2011
Last updated
10/10/2011
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