KILBOURN GORDON III (NPI# 1952455693) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952455693 |
| Entity Type | Individual |
| Full Name | KILBOURN GORDON III |
| Credential | MD |
| Practice Address |
226 Mill Hill Ave 3rd Floor Bridgeport CT 06610-2826 |
| Mailing Address |
Po Box 415126 Mill Hill Medical Consultants, Inc. Boston MA 02241-0001 |
| Practice Telephone | 2033843394 |
| Practice Fax Number | 2033843829 |
| Mailing Telephone | 2033843394 |
| Mailing Fax Number | 2033843829 |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2008-06-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 038689 | CT | Allopathic & Osteopathic Physicians |
| Y | 208D00000X | General Practice | 038689 | CT | Allopathic & Osteopathic Physicians |
| Street Address |
226 MILL HILL AVE 3RD FLOOR |
| City | BRIDGEPORT |
| State | CT |
| Zip Code | 06610-2826 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093719700 | Armand John Wolff | Internal Medicine | 226 Mill Hill Ave, 3rd Floor, Bridgeport, CT 06610-2826 | 2005-06-09 |
| 1306443296 | Zachary Edward Cipriano | Speech-Language Pathologist | 226 Mill Hill Ave, Bridgeport, CT 06610-2826 | 2020-10-05 |
| 1417560459 | Susan Carol Carbine | Physical Medicine & Rehabilitation | 226 Mill Hill Ave, Bridgeport, CT 06610-2826 | 2020-08-28 |
| 1013540319 | Erin Rudiak | Nurse Practitioner | 226 Mill Hill Ave, Bridgeport, CT 06610-2826 | 2020-02-15 |
| 1609436088 | Megan Charleston | Physical Therapist | 226 Mill Hill Ave, Bridgeport, CT 06610 | 2019-06-18 |
| 1962066993 | Metehan Imamoglu | Student in an Organized Health Care Education/Training Program | 226 Mill Hill Ave, Bridgeport, CT 06610-2826 | 2019-04-25 |
| 1356905319 | Marisa Beals | Student in an Organized Health Care Education/Training Program | 226 Mill Hill Ave, Bridgeport, CT 06610-2826 | 2019-04-25 |
| 1538722418 | Laura Tafuri | Student in an Organized Health Care Education/Training Program | 226 Mill Hill Ave, Bridgeport, CT 06610-2826 | 2019-04-17 |
| 1396208526 | Omar Tarek Sobh | Student in an Organized Health Care Education/Training Program | 226 Mill Hill Ave, Bridgeport, CT 06610-2826 | 2019-04-14 |
| 1659850196 | Alexandra Theresa Nelson | Speech-Language Pathologist | 226 Mill Hill Ave, Bridgeport, CT 06610-2826 | 2018-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215553698 | Juan G Farfan | Nurse Anesthetist, Certified Registered | 267 Grant Sreet, Bridgeport, CT 06610 | 2020-06-22 |
| 1104446145 | Deepak Rajkumar Vangipuram | Student in an Organized Health Care Education/Training Program | Department of Medicine, Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610 | 2020-04-20 |
| 1275152886 | Soniya Abraham | Student in an Organized Health Care Education/Training Program | Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610 | 2020-04-14 |
| 1538621834 | Yu Mi Kang | Student in an Organized Health Care Education/Training Program | 267 Grant Street, Yale New Haven Health/bridgeport Hosp, Bridgeport, CT 06610 | 2019-04-04 |
| 1073075024 | Ashwin Pramod Deshmukh | Student in an Organized Health Care Education/Training Program | Yale New Haven Health / Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610 | 2019-04-01 |
| 1790246866 | Prachi Mangesh Pednekar | Student in an Organized Health Care Education/Training Program | Yale New Haven Health/bridgeport Hospital, 261 Grant Street Department of Internal Medicine, Bridgeport, CT 06610 | 2019-03-29 |
| 1194247916 | Jessica M. Maddern | Social Worker | 1558 Barnum Avenue, Building C, Bridgeport, CT 06610 | 2017-07-13 |
| 1922532746 | Megha Kureti | Student in an Organized Health Care Education/Training Program | 267 Grant St Fl 3, Bridgeport, CT 06610 | 2017-04-18 |
| 1831623099 | Cynthia Joseph Walters | Nurse Anesthetist, Certified Registered | Bridgeport Hospital-anesthesia Department, 267 Grant Street, Bridgeport, CT 06610 | 2017-04-14 |
| 1285186148 | Helen Leahy | Nurse Practitioner | 439 Mill Hill Ave., Bridgeport, CT 06610 | 2016-10-26 |
| Find all providers in zip 06610 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| 1912142001 | Bridgeport Express Care Inc | General Practice | 2 Chenoweth Dr, Bridgeport, WV 26330-1688 | 2008-12-04 |
| 1497735435 | Chris Joas | General Practice | Bldg 3005, Sr 108, Dewert Branch Health Clinic, Mcmwtc, Bridgeport, CA 93517 | 2006-01-17 |
| 1144754177 | Premkumar Chandrakantbhai Patel | General Practice | 527 Medical Park Dr, Suite 500, Bridgeport, WV 26330-9008 | 2017-04-17 |
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|---|---|---|---|---|
| 1669029773 | Medexpress Primary Care Texas, P.a. | General Practice | 185 Asylum Street, City Place 1, Hartford, CT 06103-3408 | 2019-08-22 |
| 1225510571 | David Warren Boxwell | General Practice | 67 Church St., Suite 300, Norwich, CT 06360-0636 | 2018-09-04 |
| 1407234685 | Adrian Kenneth Wyllie | General Practice | 4 Research Pkwy, Wallingford, CT 06492-1929 | 2015-05-08 |
| 1740612829 | Stanley Brovender | General Practice | 773b Pontiac Lane, Stratford, CT 06614 | 2013-07-31 |
| 1528300191 | Theodore Herbert Johnson | General Practice | 141 S Mountain Dr, New Britain, CT 06052-1511 | 2013-03-21 |
| 1811237142 | Jose Buhain | General Practice | 19 Judson Ave Apt 5d, Woodbury, CT 06798-2844 | 2013-02-23 |
| 1548520661 | Cynthia Zywocinski | General Practice | 92 Everit St, New Haven, CT 06511-1321 | 2012-05-23 |
| 1093071631 | Roger Joseph Branson | General Practice | 12 Woodcreek Rd, Bethlehem, CT 06751-1705 | 2012-04-09 |
| 1427323401 | Kevin David Wolter | General Practice | 43 Oxford Ct, Mystic, CT 06355-1705 | 2012-03-09 |
| 1144590191 | Richard John Annulli | General Practice | 1037 Valley Rd, New Canaan, CT 06840-2818 | 2012-01-09 |
| Find all providers with the same taxonomy | ||||
| City | BRIDGEPORT |
| Zip Code | 06610 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.