Provider Demographics
NPI:1407060569
Name:KILGORE, APRIL E (MD)
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:E
Last Name:KILGORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2719 SE I ST
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-3996
Mailing Address - Country:US
Mailing Address - Phone:479-273-5437
Mailing Address - Fax:479-273-9932
Practice Address - Street 1:2719 SE I ST
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-3996
Practice Address - Country:US
Practice Address - Phone:479-273-5437
Practice Address - Fax:479-273-9932
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV239592080P0208X, 208000000X
KYTP0832080P0208X
ARE-10917208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100117820Medicaid
WV3810017714Medicaid
AR224766001Medicaid
KYK169610Medicare PIN
WV3810017714Medicaid