Individual
DR. MARTIN JON KILEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.,M.P.H.
Contact information
Practice address
SANTA ANA CLINIC, O2-C DOVE RD, BERNALILLO, NM 87004
(505) 867-2497
(505) 867-1526
Mailing address
1 SAGEBRUSH ST., ISLETA HEALTH CENTER, ISLETA, NM 87022
(505) 869-4866
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
6242
MT
207Q00000X
Family Medicine Physician
MD2014-0014
NM
Other
Enumeration date
06/22/2007
Last updated
07/12/2018
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