MEDICARE: BARBARA JEAN KILIAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	240543	NY
2	207P00000X	Emergency Medicine Physician	A104691	CA

General Provider Information

NPI Number	:	1306869342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA JEAN KILIAN MD

Provider Business Mailing Address
First Line	:	647 N MAIN ST
Second Line	:
City	:	FORT BRAGG
State	:	CA
Zip	:	95437-3219
Country	:	US
Telephone Number	:	917-327-1516
Fax Number	:	866-728-2931

Provider Business Practice Location Address
First Line	:	647 N MAIN ST
Second Line	:
City	:	FORT BRAGG
State	:	CA
Zip	:	95437-3219
Country	:	US
Telephone Number	:	917-327-1516
Fax Number	:	866-728-2931

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	07/02/2025

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