1386601656 NPI number — DR. ETHEL R BAYLOR DPM

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386601656 NPI number — DR. ETHEL R BAYLOR DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BAYLOR
Provider First Name:
ETHEL
Provider Middle Name:
R
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386601656
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/18/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 519
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WOODS HOLE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02543
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-457-1019
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
342A GIFFORD ST
Provider Second Line Business Practice Location Address:
FALMOUTH PODIATRY
Provider Business Practice Location Address City Name:
FALMOUTH
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02540
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-540-5164
Provider Business Practice Location Address Fax Number:
508-540-5175
Provider Enumeration Date:
04/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  1850 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com