Individual
DR. LARRY J BAYLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
7736 ORTONVILLE RD, STE. A, CLARKSTON, MI 48348-4483
(248) 625-5885
(248) 625-6794
Mailing address
7736 ORTONVILLE RD, STE. A, CLARKSTON, MI 48348-4483
(248) 625-5885
(248) 625-6794
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101010781
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080127004
MEDICARE RAILROAD
MI
01
—
5630195
BCBS
MI
Enumeration date
06/08/2006
Last updated
09/06/2012
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