Individual
DR. JAMES WENDALL KILLIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
402 CUMBERLAND AVE, WILLIAMSBURG, KY 40769-1238
(606) 549-2656
(606) 549-2855
Mailing address
PO BOX 540, JELLICO, TN 37762-0540
(423) 784-8492
(423) 784-8358
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
34305
TN
207Q00000X
Family Medicine Physician
Primary
35670
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
034305
STATE LICENSE
TN
01
—
35670
STATE LICENSE
KY
05
—
64017809
—
KY
05
—
Q022263
—
TN
Enumeration date
05/24/2005
Last updated
03/07/2023
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