Provider Demographics
NPI:1124088554
Name:KILPATRICK, DAVID M (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:M
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 1:1740H DELL RANGE BLVD
Mailing Address - Street 2:206
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-4946
Mailing Address - Country:US
Mailing Address - Phone:307-630-0970
Mailing Address - Fax:
Practice Address - Street 1:1740H DELL RANGE BLVD
Practice Address - Street 2:206
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-4946
Practice Address - Country:US
Practice Address - Phone:307-630-0970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY5427A207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine