Healthcare Provider Details

I. General information

NPI: 1336567395
Provider Name (Legal Business Name): GEORGE LEROY KILLION PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2014
Last Update Date: 04/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11312 LINDALEE LN
BAKERSFIELD CA
93312-3503
US

IV. Provider business mailing address

11312 LINDALEE LN
BAKERSFIELD CA
93312-3503
US

V. Phone/Fax

Practice location:
  • Phone: 661-331-8727
  • Fax:
Mailing address:
  • Phone: 661-331-8727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number40025
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: