Organization
MKILGANNONMD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL KILGANNON (OWNER)
(860) 283-2839
Entity
Organization
Contact information
Practice address
14 CLUB RD, WINDHAM, CT 06280-1000
(860) 456-1107
(860) 283-9468
Mailing address
60 FIELDSTONE DR, STORRS, CT 06268-2572
(860) 283-2839
(860) 283-9468
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
025777
CT
Other
Enumeration date
04/28/2016
Last updated
04/28/2016
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