Individual
KELLY J BAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
901 PATIENTS FIRST DR, WASHINGTON, MO 63090-4700
(636) 239-4100
(636) 390-4341
Mailing address
901 PATIENTS FIRST DR, WASHINGTON, MO 63090-4700
(636) 239-4100
(636) 390-4341
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
101371
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080121864
RAILROAD MEDICARE
—
05
—
203380738
—
MO
01
—
P01134656
RAILROAD MEDICARE
MO
Enumeration date
06/10/2006
Last updated
09/15/2014
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