MEDICARE: LINELL BAYLIS MD

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
1	208600000X	Surgery Physician	MD037736L	PA

Other Identifiers

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

General Provider Information

NPI Number	:	1306810767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINELL BAYLIS MD

Provider Business Mailing Address
First Line	:	6100 W JEFFERSON ST
Second Line	:	1ST FLOOR
City	:	PHILADELPHIA
State	:	PA
Zip	:	19151-3901
Country	:	US
Telephone Number	:	215-877-0100
Fax Number	:	215-877-7014

Provider Business Practice Location Address
First Line	:	6100 W JEFFERSON ST
Second Line	:	1ST FLOOR
City	:	PHILADELPHIA
State	:	PA
Zip	:	19151-3901
Country	:	US
Telephone Number	:	215-877-0100
Fax Number	:	215-877-7014

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	10/09/2015

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Directions to “ LINELL BAYLIS MD” Practice Location

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