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Individual

MR. BARRY JOSEPH KILBOURNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
309 COUNTY ROUTE 47, SUITE 1, SARANAC LAKE, NY 12983-5405
(518) 891-2688
(518) 891-4120
Mailing address
309 COUNTY ROUTE 47, SUITE 1, SARANAC LAKE, NY 12983-5405
(518) 891-2688
(518) 891-4120

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
129150
NY
207RG0100X
Gastroenterology Physician
129150
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000401212001
BLUE SHIELD OF NENY
NY
05
00459467
NY
01
109016
MVP SELECT
NY
01
1619977675
FIDELIS
NY
01
50E101
BCBS
NY
01
DD2645
PALMETTO GBA
NY
01
P00000040484
GHI FHP
NY
Enumeration date
07/29/2005
Last updated
05/14/2008
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