1700839073 NPI number — KEVIN ROBERT BAYES D.O.

Table of content: KEVIN ROBERT BAYES D.O. (NPI 1700839073)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700839073 NPI number — KEVIN ROBERT BAYES D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BAYES
Provider First Name:
KEVIN
Provider Middle Name:
ROBERT
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
M

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:
1700839073
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/30/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 390
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTINGTON
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25708-0390
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-429-1088
Provider Business Mailing Address Fax Number:
304-429-3109

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
404 EUCLID AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PAINTSVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41240-1167
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-889-1602
Provider Business Practice Location Address Fax Number:
606-263-4467
Provider Enumeration Date:
05/18/2006

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: 207QH0002X , with the licence number:  02934 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 02934 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1225293 . This is a "CHA HEALTH INS." identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000379366 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 52597 . This is a "BLUE GRASS INSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 64110414 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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