Provider Demographics
NPI:1770526410
Name:KILGORE, JOHN E (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:KILGORE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:430 MORTON PLANT ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3395
Mailing Address - Country:US
Mailing Address - Phone:727-461-6026
Mailing Address - Fax:727-461-7446
Practice Address - Street 1:430 MORTON PLANT ST
Practice Address - Street 2:SUITE 301
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3395
Practice Address - Country:US
Practice Address - Phone:727-461-6026
Practice Address - Fax:727-461-7446
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 0061083207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL379784800Medicaid
FL379784800Medicaid
FL25629ZMedicare PIN