| Mkilgannonmd Llc | |
|
14 Club Rd Windham CT 06280-1000 | |
| (860) 456-1107 | |
| (860) 283-9468 |
| Full Name | Mkilgannonmd Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 14 Club Rd, Windham, Connecticut |
| Authorized Official Name and Position | Michael Kilgannon (OWNER) |
| Authorized Official Contact | 8602832839 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mkilgannonmd Llc 60 Fieldstone Dr Storrs CT 06268-2572 Ph: (860) 283-2839 | Mkilgannonmd Llc 14 Club Rd Windham CT 06280-1000 Ph: (860) 456-1107 |
| NPI Number | 1437504388 |
|---|---|
| Provider Enumeration Date | 04/28/2016 |
| Last Update Date | 04/28/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437504388 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 025777 (Connecticut) | Primary |