Provider Demographics
NPI:1164474557
Name:KILLION, KARL D (DO)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:D
Last Name:KILLION
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:211 SAINT FRANCIS DRIVE
Mailing Address - Street 2:MEDICAL AFFAIRS
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63703-5049
Mailing Address - Country:US
Mailing Address - Phone:573-331-5583
Mailing Address - Fax:573-331-5079
Practice Address - Street 1:515 MAPLE VALLEY DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640-1919
Practice Address - Country:US
Practice Address - Phone:573-760-7920
Practice Address - Fax:573-756-9597
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2020-03-13
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Provider Licenses
StateLicense IDTaxonomies
MOR7E83207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1164474557Medicaid
A12938Medicare UPIN
MO1164474557Medicaid