Individual
JEFFREY H KIVIAT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 MEMORIAL DR, ALTON, IL 62002-6722
(618) 463-7410
(618) 463-7641
Mailing address
PO BOX 952009, SAINT LOUIS, MO 63195-2009
(314) 821-8055
(314) 821-1833
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100723
HEALTHLINK
—
01
—
31740
GHP
—
01
—
4000541
AETNA
—
01
—
45307
GHP
—
Enumeration date
12/01/2005
Last updated
07/08/2007
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