Provider Demographics
NPI:1326783127
Name:POWERS, KILEY (CSFA)
Entity Type:Individual
Prefix:
First Name:KILEY
Middle Name:
Last Name:POWERS
Suffix:
Gender:F
Credentials:CSFA
Other - Prefix:
Other - First Name:KILEY
Other - Middle Name:
Other - Last Name:DOSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:310 SESSLIE OAK DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31419-8391
Mailing Address - Country:US
Mailing Address - Phone:678-634-3758
Mailing Address - Fax:
Practice Address - Street 1:210 E DERENNE AVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-6736
Practice Address - Country:US
Practice Address - Phone:912-644-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical