DR. KENNETH WILLIAM KING O.D. NPI 1174524722

NPI Information

NPI: 1174524722
Provider Name: DR. KENNETH WILLIAM KING, O.D.
Classification: Optometrist - 152WC0802X
Entity Type: Individual

Specialization: Corneal and Contact Management

PECOS Registration: Yes

Address:
1480 E LINCOLN RD
IDAHO FALLS, ID
ZIP 83401
Phone: (208) 525-8686
Get Directions

DR. Kenneth William King, O.D. is a corneal and contact management optometrist in Idaho Falls, ID. The provider is the professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea's ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. DR. Kenneth William King, O.D. NPI is 1174524722. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1480 E LINCOLN RD
IDAHO FALLS, ID
ZIP 83401-128
Phone: (208) 525-8686
Fax: (208) 525-8684

The NPI 1174524722 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 8/4/2005 and was last updated on 12/20/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	152WC0802X	Optometrist	Corneal and Contact Management	ODP0467	IDAHO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	I-902428	OTHER		CHAMPUS
2	82052	OTHER	IDAHO	BLUE SHIELD
3	1590638	MEDICARE ID-TYPE UNSPECIFIED	IDAHO
4	0605250001	OTHER		DMERC
5	T44293	MEDICARE UPIN	IDAHO
6	410006556	MEDICARE ID-TYPE UNSPECIFIED		RAILROAD MEDICARE
7	002543100	MEDICAID	IDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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