Provider Demographics
NPI:1336120179
Name:BAIER, JEFFREY LEONARD (DC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:LEONARD
Last Name:BAIER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 E KANSAS PLZ
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-5870
Mailing Address - Country:US
Mailing Address - Phone:620-275-8080
Mailing Address - Fax:620-275-8081
Practice Address - Street 1:1109 E KANSAS PLZ
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-5870
Practice Address - Country:US
Practice Address - Phone:620-275-8080
Practice Address - Fax:620-275-8081
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4740111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00189220Medicare ID - Type UnspecifiedRAILROAD MEDICARE
KS062141Medicare ID - Type Unspecified