| Mark E King, PA | |
|
1401 Sudderth Dr, Ruidoso, NM 88345-6104 | |
| (575) 257-7712 | |
| (575) 257-4513 |
| Full Name | Mark E King |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 32 Years |
| Location | 1401 Sudderth Dr, Ruidoso, New Mexico |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457442691 | NPI | - | NPPES |
| 3016KI | Other | WA | BSWA |
| 0220796 | Other | WA | LIWA |
| 605960011 | Other | WA | USDLAB |
| 8464794 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | 95-PA19 (New Mexico) | Primary |
| 207P00000X | Emergency Medicine | 10003262 (Washington) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Christus St Vincent Regional Medical Center | Santa fe, NM | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| St Vincent Hospital | 6608775135 | 335 |
| Entity Name | St Vincent Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063367803 PECOS PAC ID: 6608775135 Enrollment ID: O20040105000372 |
| Entity Name | Curry Emergency Group LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508223082 PECOS PAC ID: 1759687064 Enrollment ID: O20160314000822 |
| Mailing Address | Practice Location Address |
|---|---|
| Mark E King, PA 1401 Sudderth Dr, Ruidoso, NM 88345-6104 Ph: (575) 257-7712 | Mark E King, PA 1401 Sudderth Dr, Ruidoso, NM 88345-6104 Ph: (575) 257-7712 |
Sanne F Van Swol, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 211 Sudderth Dr, Ruidoso, NM 88345 Phone: 575-257-8200 Fax: 575-630-4233 |
Nicole Rigsby, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 121 El Paso Rd., Ruidoso, NM 88345 Phone: 575-630-8350 Fax: 575-257-4055 |