Organization
RONALD B KILLIAN DPM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD B. KILLIAN DPM (OWNER)
(928) 854-4307
Entity
Organization
Contact information
Practice address
1731 MESQUITE AVE, SUITE 4, LAKE HAVASU CITY, AZ 86403-5653
(928) 854-4307
(928) 854-4339
Mailing address
PO BOX 604, LAKE HAVASU CITY, AZ 86405-0604
(928) 854-4307
(928) 854-4339
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0554
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
305439
—
AZ
01
—
DO8411
RAILROAD MEDICARE
AZ
Enumeration date
01/28/2008
Last updated
07/03/2009
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