Active NPI
Ronald B Killian DPM LLC
- Podiatrist
- Lake Havasu City, AZ
National Provider Identifier
1821275355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 0554
- Legal business name
- RONALD B KILLIAN DPM LLC
- Practice address
- 1731 Mesquite Ave
Suite 4
Lake Havasu City, AZ 86403-5653 - Phone
- (928) 854-4307
- Fax
- (928) 854-4339
- NPI assigned
- Jan 28, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Ronald B. Killian, DPM
- Title
- Owner
- Phone
- (928) 854-4307
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 0554 | AZ | Primary |
Addresses
Primary practice location
1731 Mesquite Ave
Suite 4
Lake Havasu City, AZ 86403-5653
Mailing address
PO Box 604
Lake Havasu City, AZ 86405-0604
Phone (928) 854-4307
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 305439 | Medicaid | AZ | |
| DO8411 | Other | AZ | RAILROAD MEDICARE |
National Provider Directory
National Provider DirectoryLocations
1731 Mesquite Ave
Ste 4
Lk Havasu Cty, AZ 86403
Phone (480) 861-3916
1713 S Kofa Ave
Parker, AZ 85344
Phone (928) 669-7380
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Foot & Ankle Surgery Podiatrist
- Lake Havasu City, AZ
- NPI 1205813565
-
- Foot & Ankle Surgery Podiatrist
- Kingman, AZ
- NPI 1568545481
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201478400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1246579200000",
"number": "1821275355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 604",
"city": "LAKE HAVASU CITY",
"state": "AZ",
"postal_code": "864050604",
"telephone_number": "928-854-4307",
"fax_number": "928-854-4339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1731 MESQUITE AVE",
"address_2": "SUITE 4",
"city": "LAKE HAVASU CITY",
"state": "AZ",
"postal_code": "864035653",
"telephone_number": "928-854-4307",
"fax_number": "928-854-4339"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RONALD B KILLIAN DPM LLC",
"organizational_subpart": "NO",
"enumeration_date": "2008-01-28",
"last_updated": "2009-07-03",
"status": "A",
"authorized_official_last_name": "KILLIAN",
"authorized_official_first_name": "RONALD",
"authorized_official_middle_name": "B.",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "928-854-4307",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist",
"state": "AZ",
"license": "0554",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "305439",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "DO8411",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lake Havasu City, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.