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Contact Information

MARK E KING, PA
1401 SUDDERTH DR
RUIDOSO, NM88345-6104
 Phone: 575-257-7712
 Fax: 575-257-4513
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical

363AM0700X 97 Physician Assistant
 

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for MARK E KING · (Male)

NPI Number 1457442691
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 09/27/2006
Last updated 04/03/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • NM License # 95-PA19
  • WA License # 10003262
  • WA Medicaid 8464794
  • WA Other 3016KI BSWA
  • WA Other 0220796 LIWA
  • WA Other 605960011 USDLAB
Hospital affiliation(s)
  • ST VINCENT HOSPITAL - (Acute Care)
    455 ST MICHAEL'S DRIVE
    SANTA FE, NM 87505
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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