Provider Demographics
NPI:1720081946
Name:KILGO, DAVID NEAL (RPH)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:NEAL
Last Name:KILGO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 HANNA DR
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-4045
Mailing Address - Country:US
Mailing Address - Phone:479-271-0325
Mailing Address - Fax:
Practice Address - Street 1:702 SW 8TH STREET
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72716-0230
Practice Address - Country:US
Practice Address - Phone:479-277-1236
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9685183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist