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Individual

DANIEL WILLIAM KILLINGSWORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-2273
(706) 721-1158
Mailing address
1499 WALTON WAY, SUITE 1400, AUGUSTA, GA 30901-2602
(706) 828-8403

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
56307
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12092
MEDICAL LICENSE NUMBER
AL
01
56307
MEDICAL LICENSE NUMBER
GA
05
611384568A
GA
05
G56307
SC
Enumeration date
08/01/2006
Last updated
04/04/2011
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