Provider Demographics
NPI:1154359628
Name:KING, ROBERT ALLEN (MD)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ALLEN
Last Name:KING
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Gender:M
Credentials:MD
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Mailing Address - Street 1:4875 WARD ROAD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033
Mailing Address - Country:US
Mailing Address - Phone:303-456-9456
Mailing Address - Fax:303-463-7560
Practice Address - Street 1:4875 WARD ROAD
Practice Address - Street 2:SUITE 600
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033
Practice Address - Country:US
Practice Address - Phone:303-456-9456
Practice Address - Fax:303-463-7560
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2018-08-27
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Provider Licenses
StateLicense IDTaxonomies
CO24699207W00000X, 207WX0110X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01246990Medicaid
CO1246990Medicaid
COF2318Medicare ID - Type Unspecified
COD24494Medicare UPIN
CO1246990Medicaid