Provider Demographics
NPI:1215110952
Name:PATRICK F. KILHENNY, MD, PC
Entity type:Organization
Organization Name:PATRICK F. KILHENNY, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:KAVANAGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-481-3800
Mailing Address - Street 1:1012 FIRST COLONIAL ROAD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-3270
Mailing Address - Country:US
Mailing Address - Phone:757-481-3800
Mailing Address - Fax:757-481-7743
Practice Address - Street 1:1201 FIRST COLONIAL RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-2217
Practice Address - Country:US
Practice Address - Phone:757-425-5550
Practice Address - Fax:757-412-2606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-17
Last Update Date:2017-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010457852084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7116322Medicaid
VA7116322Medicaid
VAC08108Medicare PIN