Provider Demographics
NPI:1508390089
Name:KINGEEKUK, JOSEPH
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:KINGEEKUK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GENERAL DELIVERY
Mailing Address - Street 2:
Mailing Address - City:SAVOONGA
Mailing Address - State:AK
Mailing Address - Zip Code:99769-0046
Mailing Address - Country:US
Mailing Address - Phone:907-984-6635
Mailing Address - Fax:907-984-6050
Practice Address - Street 1:GENERAL DELIVERY
Practice Address - Street 2:
Practice Address - City:SAVOONGA
Practice Address - State:AK
Practice Address - Zip Code:99769-0046
Practice Address - Country:US
Practice Address - Phone:907-984-6635
Practice Address - Fax:907-984-6050
Is Sole Proprietor?:No
Enumeration Date:2017-04-12
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor