Individual provider · Type 1 NPI

Jack Eldon Kilgore Iii, MD

Student in an Organized Health Care Education/Training Program · Seattle, WA

NPI number 1558003293 Active

Practice location

1959 NE Pacific St
Seattle, WA 98195-0001

Call (206) 520-5000 Map

Mailing address

1959 NE Pacific Street, BB-928
Seattle, WA 98195

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1558003293

Jack Eldon Kilgore Iii, MD's National Provider Identifier is 1558003293, issued on Apr 12, 2022. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Seattle, WA. The record was last updated on Jun 8, 2026.