Provider Demographics
NPI:1326450032
Name:PATTON, BAILEY ELISE ROBERTS (MD)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:ELISE ROBERTS
Last Name:PATTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 HOLMES ST STE 800
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-2602
Mailing Address - Country:US
Mailing Address - Phone:816-404-8166
Mailing Address - Fax:
Practice Address - Street 1:606 S HARDY AVE
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64053-1827
Practice Address - Country:US
Practice Address - Phone:816-404-5770
Practice Address - Fax:816-404-5775
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-29
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018017477207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty