Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 5427A | WY |
NPI | 1124088554 |
---|---|
Provider Name | David M. Kilpatrick |
First Address | Cheyenne, WY 82009-4946 |
Second Address | Cheyenne, WY 82009-4946 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2006 |
Last Update Date | 28/12/2011 |