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General NPI Number Information
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NPI Number | 1629462569
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Entity Type | Individual
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Provider Name | KEVIN KILGALLON MD
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Gender | Male
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Dates
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Enumeration Date | 03/27/2015
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Last Update Date | 06/15/2020
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Provider Practice Location Address
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Address Line | 13121 E 17TH AVE
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City | AURORA
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State | CO
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Zip | 80045-2535
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Country | US
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Telephone | 303-724-2393
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Fax |
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Provider Business Mailing Address
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Address Line | 13121 E 17TH AVE
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City | AURORA
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State | CO
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Zip | 80045-2535
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Country | US
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Telephone | 303-724-2393
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0145808
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | DR.0060161
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License Number State | CO
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