Organization
KILGORE VISION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH MERLE KILGORE MD (OWNER PRESIDENT)
(870) 424-4900
Entity
Organization
Contact information
Practice address
2943 HIGHWAY 62 W, MOUNTAIN HOME, AR 72653-6535
(870) 424-4900
(870) 424-4979
Mailing address
PO BOX 444, MOUNTAIN HOME, AR 72654-0444
(870) 424-4900
(870) 424-4979
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1447253273
NPI
AR
Enumeration date
05/24/2005
Last updated
01/07/2010
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