Individual
DR. BRENDAN DYER KILLORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
049554
CT
207T00000X
Neurological Surgery Physician
80789
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
049554
CONNECTICARE
CT
05
—
1043490097
—
CT
01
—
7432716
GREAT WEST HEALTHCARE
CT
01
—
80789
TRAINING PERMIT
AZ
01
—
P4362821
OXFORD
CT
Enumeration date
11/07/2007
Last updated
12/12/2011
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