Healthcare Provider Details

I. General information

NPI: 1114912540
Provider Name (Legal Business Name): SHARON Y HARRIS-BAUGH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2005
Last Update Date: 02/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 CAISSON HILL RD
FT RILEY KS
66442-7037
US

IV. Provider business mailing address

600 CAISSON HILL RD
FT RILEY KS
66442-7037
US

V. Phone/Fax

Practice location:
  • Phone: 785-239-7794
  • Fax: 785-239-7240
Mailing address:
  • Phone: 785-239-7794
  • Fax: 785-239-7240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberR3M88
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: