Healthcare Provider Details

I. General information

NPI: 1194718064
Provider Name (Legal Business Name): ROBERT A KILPATRICK
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ROBERT A. KILPATRICK M.D.

II. Dates (important events)

Enumeration Date: 08/25/2005
Last Update Date: 10/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10101 RIDGEGATE PKWY
LONE TREE CO
80124-5522
US

IV. Provider business mailing address

PO BOX 173862
DENVER CO
80217-3862
US

V. Phone/Fax

Practice location:
  • Phone: 720-225-1000
  • Fax: 303-306-7753
Mailing address:
  • Phone: 303-306-7101
  • Fax: 303-306-7753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number11530
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number11530
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License Number11530
License Number StateNV
# 4
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME120797
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: