Basic Information
| Provider Information | |||||||||
| NPI: | 1184678252 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KILBOURN | ||||||||
| FirstName: | CYNTHIA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 555 N DUKE ST | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176022250 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175445511 | ||||||||
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| Practice Location | |||||||||
| Address1: | 694 GOOD DR | ||||||||
| Address2: | SUITE 11 | ||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176012433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175443737 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2006 | ||||||||
| LastUpdateDate: | 10/05/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD054151L | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | P002757 | 01 | PA | GATEWAY | OTHER | 000000127020 | 01 | PA | UNISON | OTHER | 769974 | 01 | PA | HEALTHAMERICA | OTHER | 20038877 | 01 | PA | AMERIHEALTH MERCY | OTHER | 0739811000 | 01 | PA | INDEPENDENCE BLUE CROSS | OTHER | 1417873 | 01 | PA | AETNA | OTHER | 50056057 | 01 | PA | CAPITAL BLUE CROSS | OTHER | 000545644 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 001492054 0008 | 05 | PA | MEDICAID |