Provider Demographics
NPI:1417436882
Name:SLACK, BAYLEI K (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:BAYLEI
Middle Name:K
Last Name:SLACK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:BAYLEI
Other - Middle Name:K
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2101 N WALDRON ST
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-1197
Mailing Address - Country:US
Mailing Address - Phone:316-480-2816
Mailing Address - Fax:316-504-6531
Practice Address - Street 1:2101 N WALDRON ST
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-1197
Practice Address - Country:US
Practice Address - Phone:620-669-2500
Practice Address - Fax:620-694-2128
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant