Organization
M.W. KILGORE, II, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANLEY W KILGORE II (PHYSICIAN)
(904) 396-2400
Entity
Organization
Contact information
Practice address
11363 SAN JOSE BLVD, SUITE 102, JACKSONVILLE, FL 32223-7957
(904) 396-2400
(904) 396-3750
Mailing address
11363 SAN JOSE BLVD, SUITE 102, JACKSONVILLE, FL 32223-7957
(904) 396-2400
(904) 396-3750
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME17133
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
059854200
—
FL
Enumeration date
09/17/2007
Last updated
11/04/2009
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