Provider Demographics
NPI:1245326743
Name:WOO, KINGSON J (MD)
Entity type:Individual
Prefix:DR
First Name:KINGSON
Middle Name:J
Last Name:WOO
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 WATER VILLAGE ROAD
Mailing Address - Street 2:
Mailing Address - City:OSSIPEE
Mailing Address - State:NH
Mailing Address - Zip Code:03864
Mailing Address - Country:US
Mailing Address - Phone:603-539-6996
Mailing Address - Fax:603-539-5284
Practice Address - Street 1:3 WATER VILLAGE ROAD
Practice Address - Street 2:
Practice Address - City:OSSIPEE
Practice Address - State:NH
Practice Address - Zip Code:03864
Practice Address - Country:US
Practice Address - Phone:603-539-6996
Practice Address - Fax:603-539-5284
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME016879207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME431954699Medicaid
ME431954699Medicaid
ME1477Medicare ID - Type Unspecified