Kilgannon, Michael A

Kilgannon, Michael A is an sole proprietor health care provider with primary practice located at 1703 Main St , Willimantic CT 06226-1162. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Kilgannon, Michael A can be contacted via phone (860) 456-1252.

Contact Information

Primary practice address
1703 Main St Willimantic CT 06226-1162
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 025777 Connecticut

Profile Details

NPI number 1164483947
LBN Legal business name Kilgannon, Michael A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 31st, 2006
Last updated Sep 4th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164483947 NPPES
Connecticut Other 25777 STATE LICENSE

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