Provider Demographics
NPI:1639117724
Name:BAYLISS, GAIL A (MD)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:A
Last Name:BAYLISS
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 1:1115 N CYPRESS ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-4058
Mailing Address - Country:US
Mailing Address - Phone:316-634-1173
Mailing Address - Fax:
Practice Address - Street 1:1115 N CYPRESS ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-4058
Practice Address - Country:US
Practice Address - Phone:316-634-1173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0428007207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200267380GMedicaid
KS200267380HMedicaid
KSE83456Medicare UPIN
KS200267380HMedicaid
KS004052018Medicare PIN
KSP00657891Medicare PIN