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Individual

MARK DUANE KILGUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
145 SUNSET CT STE 100, WEST COLUMBIA, SC 29169-2464
(803) 739-3550
(803) 739-3546
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
(803) 739-3550
(803) 739-3546

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
0101241086
VA
2084P0800X
Psychiatry Physician
Primary
14995
SC
2084P0800X
Psychiatry Physician
MD36657
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4106719
BCBS
TN
01
TN01BE
JOHN DEERE
TN
Enumeration date
04/26/2006
Last updated
03/12/2025
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