Healthcare Provider Details

I. General information

NPI: 1487746665
Provider Name (Legal Business Name): WALTER KILBY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 05/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

633 SUNSET LN SUITE A
CULPEPER VA
22701-3942
US

IV. Provider business mailing address

100 SAUNDERS ST
CULPEPER VA
22701-3826
US

V. Phone/Fax

Practice location:
  • Phone: 540-825-5381
  • Fax: 540-829-0945
Mailing address:
  • Phone: 540-829-4900
  • Fax: 540-829-4901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101019886
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: