Healthcare Provider Details

I. General information

NPI: 1144297136
Provider Name (Legal Business Name): MICHAEL A KILEY PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 HEALTH PARK DR STE 350
LOUISVILLE CO
80027-9742
US

IV. Provider business mailing address

90 HEALTH PARK DR STE 350
LOUISVILLE CO
80027-9742
US

V. Phone/Fax

Practice location:
  • Phone: 303-925-5068
  • Fax: 303-925-5069
Mailing address:
  • Phone: 303-925-5068
  • Fax: 303-925-5069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.0001403
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA.0001403
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: