Provider Demographics
NPI:1649682667
Name:KING, JAMES (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:KING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4540 S SOMMERSET DR
Mailing Address - Street 2:
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53151-6876
Mailing Address - Country:US
Mailing Address - Phone:414-422-8606
Mailing Address - Fax:480-262-5476
Practice Address - Street 1:4540 S SOMMERSET DR
Practice Address - Street 2:
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-6876
Practice Address - Country:US
Practice Address - Phone:414-422-8606
Practice Address - Fax:480-262-5476
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-26
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI18387-020207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease