Provider Demographics
NPI:1093806192
Name:BAYLOR, GEORGE M (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:M
Last Name:BAYLOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 KNOTBREAK RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-5414
Mailing Address - Country:US
Mailing Address - Phone:540-444-5670
Mailing Address - Fax:540-444-5669
Practice Address - Street 1:100 KNOTBREAK RD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153
Practice Address - Country:US
Practice Address - Phone:540-444-5670
Practice Address - Fax:540-444-5669
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101236153207LP2900X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010376327Medicaid
VAP00378985OtherMEDICARE RAILROAD
VAP00378985OtherMEDICARE RAILROAD
G30134Medicare UPIN