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General NPI Number Information
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NPI Number | 1073181822
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Entity Type | Individual
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Provider Name | BAYLEE AUSTIN DELOZIER DO
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Gender | Male
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Dates
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Enumeration Date | 06/16/2021
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 310 W LOSEY ST
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City | SCOTT AFB
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State | IL
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Zip | 62225-5250
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Country | US
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Telephone | 618-256-9355
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Fax |
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Provider Business Mailing Address
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Address Line | 3 SAINT ELIZABETH BLVD STE 4000
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City | O FALLON
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State | IL
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Zip | 62269-1284
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Country | US
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Telephone | 618-222-4600
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 9344
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 9344
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036.176132
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License Number State | IL
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