MEDICARE: JAMES R KILGORE PA-C

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	363A00000X	Physician Assistant	149	AL

General Provider Information

NPI Number	:	1154321537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES R KILGORE PA-C

Provider Business Mailing Address
First Line	:	2517 WOODFERN CIR
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35244-1467
Country	:	US
Telephone Number	:	205-987-1480
Fax Number	:	205-824-3677

Provider Business Practice Location Address
First Line	:	2517 WOODFERN CIR
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35244-1467
Country	:	US
Telephone Number	:	205-987-1480
Fax Number	:

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

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	10/13/2020

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Directions to “ JAMES R KILGORE PA-C” Practice Location

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