Provider Demographics
NPI:1235600073
Name:KILGO EYE CARE OD PLLC
Entity Type:Organization
Organization Name:KILGO EYE CARE OD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSANNE
Authorized Official - Middle Name:S
Authorized Official - Last Name:KILGO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:828-676-3260
Mailing Address - Street 1:2802 HAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-1326
Mailing Address - Country:US
Mailing Address - Phone:828-243-3712
Mailing Address - Fax:
Practice Address - Street 1:2 WALDEN RIDGE DR STE 50
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-8598
Practice Address - Country:US
Practice Address - Phone:828-676-3260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-05
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty