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NPI Code Detail

MEDICARE: DR. KATE BAYLISS MD, PHD

MEDICARE: DR. KATE BAYLISS MD, PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2207P00000XEmergency Medicine PhysicianMD203867OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194229146
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATE BAYLISS MD, PHD
Provider Business Mailing Address
First Line : 2700 NW STEWART PKWY DEPT OF
Second Line :
City : ROSEBURG
State : OR
Zip : 97471-1214
Country : US
Telephone Number : 541-673-0611
Fax Number :
Provider Business Practice Location Address
First Line : 2700 NW STEWART PKWY DEPT OF
Second Line :
City : ROSEBURG
State : OR
Zip : 97471-1214
Country : US
Telephone Number : 541-673-0611
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2018
Last Update Date : 10/11/2022

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