Provider Demographics
NPI:1447257407
Name:KILE, LAURIE B (MD)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:B
Last Name:KILE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4813 JONESTOWN RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-1748
Mailing Address - Country:US
Mailing Address - Phone:717-635-8485
Mailing Address - Fax:717-635-8554
Practice Address - Street 1:4813 JONESTOWN RD
Practice Address - Street 2:SUITE 205
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-1748
Practice Address - Country:US
Practice Address - Phone:717-635-8485
Practice Address - Fax:717-635-8554
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-06
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD060537L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH50899Medicare UPIN