Organization
KEVIN E. BAILL MD & ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN ELLIOT BAILL MD (PRESIDENT)
(917) 447-2138
Entity
Organization
Contact information
Practice address
345 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4800
(917) 447-2138
Mailing address
345 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4800
(917) 447-2138
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
12179
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4939170
—
RI
Enumeration date
01/24/2014
Last updated
01/24/2014
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