Individual
DR. BRANDON HEATH KILGORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3555 HARDEN STREET EXT STE 141, COLUMBIA, SC 29203
(803) 434-4300
(803) 434-4351
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
23447
OK
2084P0800X
Psychiatry Physician
Primary
61328
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200199860A
—
OK
05
—
613287
—
SC
Enumeration date
02/07/2007
Last updated
05/29/2019
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