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General NPI Number Information
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NPI Number | 1619364999
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Entity Type | Individual
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Provider Name | KISSONIE SANSHIA MCDONALD BAIR M.D
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Gender | Female
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Dates
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Enumeration Date | 04/23/2015
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 929 N US HWY 441
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City | LADY LAKE
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State | FL
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Zip | 32159-3001
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Country | US
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Telephone | 352-783-1767
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Fax | 352-433-1084
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Provider Business Mailing Address
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Address Line | 929 N US HWY 441 STE 201
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City | LADY LAKE
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State | FL
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Zip | 32159-3002
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Country | US
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Telephone | 352-783-1767
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Fax | 352-433-1084
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME152940
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License Number State | FL
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