Individual
DR. DALLAS JORDAN KINGSBURY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
251 5TH AVE FL 7, NEW YORK, NY 10016-6515
(917) 780-5300
(347) 685-9101
Mailing address
PO BOX 1734, NAPLES, FL 34106-1734
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
269706
NY
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
269706
NY
Other
Enumeration date
03/14/2012
Last updated
06/05/2025
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