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JEREMY MICHAEL KILBURN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 560-6917
(864) 560-6017
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
157108
NC
2085R0001X
Radiation Oncology Physician
Primary
36715
SC
2085R0001X
Radiation Oncology Physician
TL36715
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
367150
SC
01
SC35947652
MEDICARE PIN
SC
Enumeration date
06/03/2009
Last updated
05/31/2023
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