Provider Demographics
NPI:1255426177
Name:KILPATRICK, GEORGE R JR (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:R
Last Name:KILPATRICK
Suffix:JR
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 1:601 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-6054
Mailing Address - Country:US
Mailing Address - Phone:336-275-7658
Mailing Address - Fax:336-275-8375
Practice Address - Street 1:601 E MARKET ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-6054
Practice Address - Country:US
Practice Address - Phone:336-275-7658
Practice Address - Fax:336-275-8375
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC18881207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8948945Medicaid
NC04-01716OtherUNITED HEALTHCARE
NC48945OtherBCBS/STATE
NC700OtherPARTNERS
NC8948945Medicaid
NC48945OtherBCBS/STATE