Provider Demographics
NPI:1043271240
Name:BAYS,, KENT DAVID (PA)
Entity Type:Individual
Prefix:
First Name:KENT
Middle Name:DAVID
Last Name:BAYS,
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:KENT
Other - Middle Name:DAVID
Other - Last Name:BAYS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:500 E ROBINSON ST
Mailing Address - Street 2:SUITE 1300
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-6697
Mailing Address - Country:US
Mailing Address - Phone:405-360-9966
Mailing Address - Fax:405-360-9905
Practice Address - Street 1:500 E ROBINSON ST
Practice Address - Street 2:SUITE 1300
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-6697
Practice Address - Country:US
Practice Address - Phone:405-360-9966
Practice Address - Fax:405-360-9905
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1234363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKP82225Medicare UPIN