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General NPI Number Information
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NPI Number | 1487970653
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Entity Type | Individual
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Provider Name | WALID ELIE BAZ M.D
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Gender | Male
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Dates
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Enumeration Date | 04/13/2010
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Last Update Date | 06/07/2011
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Provider Practice Location Address
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Address Line | 306 HOSPITAL DR
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City | SOUTH WILLIAMSON
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State | KY
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Zip | 41503-4095
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Country | US
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Telephone | 606-237-4958
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Fax |
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Provider Business Mailing Address
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Address Line | 306 HOSPITAL DR
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City | SOUTH WILLIAMSON
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State | KY
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Zip | 41503-4095
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Country | US
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Telephone | 606-237-4958
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 43240
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | ME105476
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License Number State | FL
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