Individual
MICHAEL EUGENE KILKENNY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
US 60 AT 4TH STREET, STORE ROOM #6, CEREDO, WV 25507-1249
(304) 453-3050
Mailing address
PO BOX 1249, CEREDO, WV 25507-1249
(304) 453-3050
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13536
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0050099000
—
WV
Enumeration date
01/24/2006
Last updated
10/12/2012
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