Organization
KENNETH R KILIAN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH R KILIAN M.D. (PRESIDENT)
(636) 933-9300
Entity
Organization
Contact information
Practice address
1390 US HIGHWAY 61, SUITE 2200, FESTUS, MO 63028-4137
(636) 933-9300
(636) 933-9114
Mailing address
1390 US HIGHWAY 61, SUITE 2200, FESTUS, MO 63028-4137
(636) 933-9300
(636) 933-9114
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2002022533
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
507485407
—
MO
01
—
DG2485
RAILROAD MEDICARE
MO
Enumeration date
06/22/2007
Last updated
10/19/2010
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