Organization
JOHN KILGALLIN M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN KILGALLIN M.D. (OWNER)
(270) 866-3161
Entity
Organization
Contact information
Practice address
124 DOWELL RD, RUSSELL SPRINGS, KY 42642-4278
(270) 866-3161
(270) 866-3163
Mailing address
124 DOWELL RD, RUSSELL SPRINGS, KY 42642-4278
(270) 866-3161
(270) 866-3163
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25723
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000049266
ANTHEM BC/BS
KY
01
—
000000202451
ANTHEM BC/BS
KY
05
—
65935983
—
KY
05
—
78902103
—
KY
Enumeration date
09/01/2006
Last updated
03/20/2008
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