# KEVIN E. BAILL MD & ASSOCIATES, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003239286
- **Authorized official:** DR. KEVIN ELLIOT BAILL MD (PRESIDENT)
- **Authorized official phone:** (917) 447-2138

## Contact information

- **Practice address:** 345 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4800
- **Practice address phone:** (917) 447-2138
- **Mailing address:** 345 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4800
- **Mailing address phone:** (917) 447-2138

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 12179 | RI | Yes |

## Other

- **Enumeration date:** 01/24/2014
- **Last updated:** 01/24/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4939170 | — | RI |