Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 042-0008003 | VT |
NPI | 1245345917 |
---|---|
Provider Name | Dr. Peter Knight King |
First Address | Bennington, VT 05201-1858 |
Second Address | Bennington, VT 05201-1858 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 08/07/2007 |