# MARK R. KILLMAN, M.D. P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285828913
- **Authorized official:** DR. MARK RAY KILLMAN M.D. (PHYSICIAN, PRESIDENT)
- **Authorized official phone:** (816) 254-9595

## Contact information

- **Practice address:** 19550 E 39TH ST S, SUITE 415, INDEPENDENCE, MO 64057-2303
- **Practice address phone:** (816) 254-9595
- **Practice address fax:** (816) 836-3810
- **Mailing address:** 19550 E 39TH ST S, SUITE 415, INDEPENDENCE, MO 64057-2303
- **Mailing address phone:** (816) 254-9595
- **Mailing address fax:** (816) 836-3810

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 107716 | MO | Yes |

## Other

- **Enumeration date:** 09/06/2007
- **Last updated:** 09/06/2007