Individual
KEVIN E. BAILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
345 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4800
(401) 455-6663
(401) 455-6592
Mailing address
345 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4800
(401) 455-6663
(401) 455-6592
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
16936
ME
2084P0800X
Psychiatry Physician
Primary
MD12179
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007059177
MEDICARE ID-TYPE UNSPECIFIED
RI
01
—
1093831646
BUTLER HOSPITAL PROFESSIONAL BILLING OFFICE
—
01
—
1104801349
BUTLER HOSPITAL NPI
RI
01
—
32135-8
BLUE CROSS
RI
01
—
413937
BLUE CHIP
RI
05
—
432058299
—
ME
05
—
4939170
—
RI
Enumeration date
08/11/2006
Last updated
05/04/2023
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