Mkilgannonmd Llc | |
14 Club Rd Windham CT 06280-1000 | |
(860) 456-1107 | |
(860) 283-9468 |
Full Name | Mkilgannonmd Llc |
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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 |
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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 |
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Provider Enumeration Date | 04/28/2016 |
Last Update Date | 04/28/2016 |
Identifier | Type | State | Issuer |
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1437504388 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | 025777 (Connecticut) | Primary |