Individual
RONALD BERNARD KILLIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
25 RIVIERA BLVD, LAKE HAVASU CITY, AZ 86403-5694
(928) 505-5555
(928) 505-2877
Mailing address
25 RIVIERA BLVD, LAKE HAVASU CITY, AZ 86403-5694
(928) 505-5555
(928) 505-2877
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
0554
AZ
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0554
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
305439
—
AZ
Enumeration date
12/28/2005
Last updated
07/16/2012
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