| Michael E Kilkenny Md | |
|
514 Hendricks Street Wayne WV 25570-0729 | |
| (304) 272-3005 | |
| (304) 272-3335 |
| Full Name | Michael E Kilkenny Md |
|---|---|
| Speciality | Clinic/center |
| Location | 514 Hendricks Street, Wayne, West Virginia |
| Authorized Official Name and Position | Michael E Kilkenny (OWNER) |
| Authorized Official Contact | 3042723005 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael E Kilkenny Md Po Box 729 Wayne WV 25570-0729 Ph: (304) 272-3005 | Michael E Kilkenny Md 514 Hendricks Street Wayne WV 25570-0729 Ph: (304) 272-3005 |
| NPI Number | 1639264146 |
|---|---|
| Provider Enumeration Date | 10/03/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639264146 | NPI | - | NPPES |
| 0050099000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 13536 (West Virginia) | Primary |
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