Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | MD042864L | PA |
NPI | 1013941533 |
---|---|
Provider Name | Dr. Joseph Thomas King JR. |
First Address | West Haven, CT 06516-2770 |
Second Address | West Haven, CT 06516-2770 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 08/07/2007 |