Provider Demographics
NPI:1942248398
Name:KILLIAN, PHILLIP ANDREW (PA-C)
Entity Type:Individual
Prefix:MR
First Name:PHILLIP
Middle Name:ANDREW
Last Name:KILLIAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 FAIRGROVE CHURCH RD S.E.
Mailing Address - Street 2:CATAWBA VALLEY MEDICAL CENTER
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602
Mailing Address - Country:US
Mailing Address - Phone:828-326-3230
Mailing Address - Fax:828-326-2855
Practice Address - Street 1:810 FAIRGROVE CHURCH RD S.E.
Practice Address - Street 2:CATAWBA VALLEY MEDICAL CENTER
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602
Practice Address - Country:US
Practice Address - Phone:828-326-3230
Practice Address - Fax:828-326-2855
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0001-01794363A00000X
NC1017994363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
D8992OtherMEDCOST
S34218Medicare UPIN
2472997DMedicare PIN