Individual
KENNETH W. KILGORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
46 COPPERFIELD CIR, LITITZ, PA 17543-9482
(717) 626-7666
(717) 626-1605
Mailing address
46 COPPERFIELD CIR, LITITZ, PA 17543-9482
(717) 626-7666
(717) 626-1605
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
SC004716-L
PA
213ER0200X
Radiology Podiatrist
SC004716-L
PA
213ES0131X
Foot Surgery Podiatrist
Primary
SC004716-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0477086001
PIN FOR CIGNA
PA
01
—
13162415
PIN FOR WASAU
PA
01
—
1410834
PIN FOR HIGHMARK
PA
01
—
2102717
PIN FOR MAMSI
PA
01
—
2280961
IMPIN FOR UNITEDHEALTHCAR
PA
01
—
50007507
PIN FOR CAP BLUE CROSS
PA
Enumeration date
07/15/2006
Last updated
01/17/2008
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