Provider Demographics
NPI:1760020077
Name:BAYLON, MATTHEW SHORT (PA-C)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:SHORT
Last Name:BAYLON
Suffix:
Gender:M
Credentials:PA-C
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Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9410 W ALEX AVE
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-8312
Mailing Address - Country:US
Mailing Address - Phone:602-810-3579
Mailing Address - Fax:
Practice Address - Street 1:13965 N 75TH AVE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-6097
Practice Address - Country:US
Practice Address - Phone:602-843-2991
Practice Address - Fax:602-978-1226
Is Sole Proprietor?:No
Enumeration Date:2019-12-17
Last Update Date:2021-02-27
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant