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Individual

KEVIN KILLIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
205 N EAST AVE, JACKSON, MI 49201-1753
(517) 205-4800
Mailing address
205 N EAST AVE, JACKSON, MI 49201-1753

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5101026954
MI
207PS0010X
Sports Medicine (Emergency Medicine) Physician
34.017130
OH
390200000X
Student in an Organized Health Care Education/Training Program
34.017130
OH
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/28/2020
Last updated
04/25/2024
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