Individual
DR. MICHAEL A KILGANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1703 MAIN ST, WILLIMANTIC, CT 06226-1162
(860) 456-1252
Mailing address
1290 SILASE DEANE HWY, WETHERSFIELD, CT 06109-4337
(860) 972-6970
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
025777
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25777
STATE LICENSE
CT
Enumeration date
03/31/2006
Last updated
09/04/2019
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