MEDICARE: JAMES KILGORE DPM

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	213E00000X	Podiatrist	80117	MS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00124686	OTHER	MS	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437153715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES KILGORE DPM

Provider Business Mailing Address
First Line	:	PO BOX 2763
Second Line	:
City	:	COLUMBUS
State	:	MS
Zip	:	39704-2763
Country	:	US
Telephone Number	:	662-327-8910
Fax Number	:

Provider Business Practice Location Address
First Line	:	116 LAWRENCE DR
Second Line	:	STE 2
City	:	COLUMBUS
State	:	MS
Zip	:	39702-5319
Country	:	US
Telephone Number	:	662-327-8910
Fax Number	:

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

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	11/11/2008

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