Provider Demographics
NPI:1902987647
Name:KING, JAMES E (HIS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:KING
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 CHESHIRE LANE N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55446
Mailing Address - Country:US
Mailing Address - Phone:888-333-9152
Mailing Address - Fax:763-268-4240
Practice Address - Street 1:1110 HIGHWAY 55
Practice Address - Street 2:SUITE 103
Practice Address - City:HASTINGS
Practice Address - State:MN
Practice Address - Zip Code:55033-2371
Practice Address - Country:US
Practice Address - Phone:651-437-3239
Practice Address - Fax:651-437-1066
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2247237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist