Healthcare Provider Details

I. General information

NPI: 1982861308
Provider Name (Legal Business Name): KATSIARYNA SERHEEUNA HUSEVA BAILOR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2008
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 NW 34TH ST
OKLAHOMA CITY OK
73118-8615
US

IV. Provider business mailing address

249 NW 34TH ST
OKLAHOMA CITY OK
73118-8615
US

V. Phone/Fax

Practice location:
  • Phone: 543-838-5499
  • Fax:
Mailing address:
  • Phone: 954-383-8549
  • Fax: 543-838-5499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberME123799
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2082S0099X
TaxonomyPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician
License NumberME123799
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberME123799
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: