Provider Demographics
NPI:1629050380
Name:KILEY, ROBERT C (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:C
Last Name:KILEY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:231 VENISON CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-6075
Mailing Address - Country:US
Mailing Address - Phone:719-488-1200
Mailing Address - Fax:719-488-1200
Practice Address - Street 1:1400 E BOULDER ST
Practice Address - Street 2:PEDIATRIX ASSOCIATES OF COLORADO SPRINGS, SUITE 3593
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-5533
Practice Address - Country:US
Practice Address - Phone:719-447-8812
Practice Address - Fax:719-447-8987
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO4425762080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2006171Medicaid
MAKI A35191Medicare ID - Type Unspecified
MAH82334Medicare UPIN