Provider Demographics
NPI:1275540106
Name:GILMOUR, KEVIN P (DO)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:P
Last Name:GILMOUR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 VINE ST
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037
Mailing Address - Country:US
Mailing Address - Phone:609-561-7666
Mailing Address - Fax:609-567-8347
Practice Address - Street 1:107 VINE ST
Practice Address - Street 2:SOUTH JERSEY CHEST DISEASES
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037
Practice Address - Country:US
Practice Address - Phone:609-561-7666
Practice Address - Fax:609-567-8347
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB51927207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1006475OtherOXFORD
NJ290003356OtherR R MEDICARE
NJJ26007OtherHEALTH NET
NJ0848506Medicaid
NJ110132970OtherR R MEDICARE
NJ583601OtherIBC
NJ547134OtherAETNA
NJ1006475OtherMERCY
NJE53565Medicare UPIN
NJ0848506Medicaid
E53565Medicare UPIN