Provider Demographics
NPI:1437145844
Name:KILPATRICK, WILLIAM FORD (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:FORD
Last Name:KILPATRICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 STOOPS DR
Mailing Address - Street 2:SUITE 280
Mailing Address - City:MONONGAHELA
Mailing Address - State:PA
Mailing Address - Zip Code:15063-3553
Mailing Address - Country:US
Mailing Address - Phone:724-565-5393
Mailing Address - Fax:724-565-5946
Practice Address - Street 1:100 STOOPS DR
Practice Address - Street 2:SUITE 280
Practice Address - City:MONONGAHELA
Practice Address - State:PA
Practice Address - Zip Code:15063-3553
Practice Address - Country:US
Practice Address - Phone:724-565-5393
Practice Address - Fax:724-565-5946
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-21
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD020802E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0683650Medicaid
PAKI089665Medicare ID - Type Unspecified
PA0683650Medicaid