JOHN KING PHD
Clinical Neuropsychologist
Albuquerque, New Mexico
Provider NPI: 1811977325
Provider Information:JOHN KING PHD
Gender: M
Not Sole Proprietor
Practice Location:
4001 INDIAN SCHOOL RD NE STE 310 ALBUQUERQUE, NM 87110 US
Tel: 505-404-9395 Fax: 505-299-4740
Business Mailing Address:
4001 INDIAN SCHOOL RD NE STE 310 ALBUQUERQUE, NM 87110 US
Tel: 505-404-9395 Fax: 505-299-4740
Entity Type: Individual
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | NM | 0969 |
N | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | IL | 71006364 |
Y | 103TP0016X | Behavioral Health & Social Service Providers Psychologist | NM | PSY-RXC0074 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
71006364 | IL | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin