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Individual

DR. KENNETH RICHARD KILIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1390 HIGHWAY 61, SUITE 2200, FESTUS, MO 63028-4137
(636) 933-9300
(636) 933-9114
Mailing address
1390 HIGHWAY 61, SUITE 2200, FESTUS, MO 63028-4137
(636) 933-9300
(636) 933-9114

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2002022533
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1225023955
MO
05
203307137
MO
01
P01222334
RAILROAD MEDICARE
MO
Enumeration date
09/19/2005
Last updated
04/10/2015
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