Provider Demographics
NPI:1487834941
Name:KILPATRICK, JOE V (MD)
Entity Type:Individual
Prefix:DR
First Name:JOE
Middle Name:V
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 1:3355 N ACADEMY BLVD
Mailing Address - Street 2:PMB 118
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-5125
Mailing Address - Country:US
Mailing Address - Phone:719-591-0595
Mailing Address - Fax:719-591-0638
Practice Address - Street 1:3229 W CAREFREE CIR
Practice Address - Street 2:BLDG G
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-3004
Practice Address - Country:US
Practice Address - Phone:719-591-0595
Practice Address - Fax:719-591-0638
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-13
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO31271207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
COKI49851OtherBLUE SHIELD
CO01312719Medicaid
COKI49851OtherBLUE SHIELD
CO01312719Medicaid