Individual
MR. THOMAS EUGENE KILKENNY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1165 S DORA ST, SUITE C1, UKIAH, CA 95482-8325
(707) 468-0471
(707) 468-1182
Mailing address
1165 S DORA ST, SUITE C1, UKIAH, CA 95482-8325
(707) 468-0471
(707) 468-1182
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G33772
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G337720
—
CA
01
—
200008281
RAILROAD MEDICARE
CA
Enumeration date
10/16/2006
Last updated
10/16/2012
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