Healthcare Provider Details

I. General information

NPI: 1528680642
Provider Name (Legal Business Name): CHRISTIAN LAWRENCE KILPATRICK DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2020
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E 5TH ST
SHERIDAN WY
82801-3658
US

IV. Provider business mailing address

201 E 5TH ST
SHERIDAN WY
82801-3658
US

V. Phone/Fax

Practice location:
  • Phone: 307-674-6995
  • Fax:
Mailing address:
  • Phone: 307-674-6995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMED-PHYS-LIC-126351
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number18278A
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: