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Individual

GARRY L KILPATRICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
400 E 10TH ST, ANNISTON, AL 36207-4716
(256) 235-5860
Mailing address
555 MAPLE LN, JACKSONVILLE, AL 36265-6852
(256) 435-5432
(256) 435-4718

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-033152
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
051525881
AL
01
51525881
BLUE SHIELD
AL
Enumeration date
05/10/2006
Last updated
12/01/2009
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