Individual
TIMOTHY J KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1375 VISTA LANE, CARSON CITY, NV 89703
(775) 882-2067
(775) 882-3706
Mailing address
1375 VISTA LANE, CARSON CITY, NV 89703
(775) 882-2067
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
9630
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002013142
—
NV
01
—
020047438
RAILROAD MEDICARE
NV
01
—
CC0900
BLUE CROSS BLUE SHIELD
NV
Enumeration date
04/17/2006
Last updated
06/08/2010
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