MEDICARE: CHRISTOPHER KILGORE

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	175T00000X	Peer Specialist	25-9165SUD	WV

General Provider Information

NPI Number	:	1376495374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER KILGORE

Provider Business Mailing Address
First Line	:	2910 EMERSON AVE
Second Line	:
City	:	PARKERSBURG
State	:	WV
Zip	:	26104-2519
Country	:	US
Telephone Number	:	740-856-1054
Fax Number	:

Provider Business Practice Location Address
First Line	:	2910 EMERSON AVE
Second Line	:
City	:	PARKERSBURG
State	:	WV
Zip	:	26104-2519
Country	:	US
Telephone Number	:	304-239-5355
Fax Number	:

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

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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Directions to “ CHRISTOPHER KILGORE ” Practice Location

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