MEDICARE: DR. DARREN E KILLEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	118396	MO

General Provider Information

NPI Number	:	1114920295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DARREN E KILLEN MD

Provider Business Mailing Address
First Line	:	7130 WORNALL RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64114-1344
Country	:	US
Telephone Number	:	816-523-9355
Fax Number	:	816-523-9358

Provider Business Practice Location Address
First Line	:	7130 WORNALL RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64114-1344
Country	:	US
Telephone Number	:	816-523-9355
Fax Number	:	816-523-9358

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	10/04/2010

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