Dr Kent L Killian, MD | |
16555 Manchester Rd, Suite 201, Wildwood, MO 63040-1220 | |
(636) 458-5858 | |
Not Available |
Full Name | Dr Kent L Killian |
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Gender | Male |
Speciality | Pediatrics |
Location | 16555 Manchester Rd, Wildwood, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1528034717 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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208000000X | Pediatrics | R6P03 (Missouri) | Primary |
Entity Name | Mercy Clinic East Communities |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1851335228 PECOS PAC ID: 7214827922 Enrollment ID: O20070521000006 |
Mailing Address | Practice Location Address |
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Dr Kent L Killian, MD 16555 Manchester Rd, Suite 201, Wildwood, MO 63040-1220 Ph: (636) 458-5858 | Dr Kent L Killian, MD 16555 Manchester Rd, Suite 201, Wildwood, MO 63040-1220 Ph: (636) 458-5858 |
Dr. Michael J Carney, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 16555 Manchester Rd, Suite 201, Wildwood, MO 63040 Phone: 636-458-0040 | |
Christie A Bayer, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 16555 Manchester Rd, Wildwood, MO 63040 Phone: 636-458-0040 | |
Dr. Caroline Grace Nugent, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 16555 Manchester Rd Ste 201, Wildwood, MO 63040 Phone: 636-458-5858 Fax: 636-458-6510 |