Provider Demographics
NPI:1679860522
Name:BAYLISS, JOCELYN KELLY (MD)
Entity Type:Individual
Prefix:DR
First Name:JOCELYN
Middle Name:KELLY
Last Name:BAYLISS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOCELYN
Other - Middle Name:RENEE
Other - Last Name:KELLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2100 CENTRAL AVENUE
Mailing Address - Street 2:STES 6 & 7
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904-6709
Mailing Address - Country:US
Mailing Address - Phone:706-364-3461
Mailing Address - Fax:706-364-3481
Practice Address - Street 1:2100 CENTRAL AVENUE
Practice Address - Street 2:STES 6 & 7
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-6709
Practice Address - Country:US
Practice Address - Phone:706-364-3461
Practice Address - Fax:706-364-3481
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0758462084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA075846OtherMEDICAL LICENSE