Healthcare Provider Details

I. General information

NPI: 1346561453
Provider Name (Legal Business Name): MARJORIE PILKINTON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2010
Last Update Date: 01/21/2021
Certification Date: 01/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4123 DUTCHMANS LN STE 307
LOUISVILLE KY
40207-4721
US

IV. Provider business mailing address

4123 DUTCHMANS LANE SUITE 307
LOUISVILLE KY
40207-4721
US

V. Phone/Fax

Practice location:
  • Phone: 212-523-5678
  • Fax:
Mailing address:
  • Phone: 502-409-5600
  • Fax: 502-259-3078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number50579
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: