Organization Name: | KEVIN E BAILL, MD AND ASSOCIATES, LLC |
NPI Number: | 1205259793 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KEVIN ELLIOT BAILL (PRESIDENT) |
Mailing Address: | 345 Blackstone Blvd Providence |
State: | RI US |
Postal Code: | 029064800 |
Phone Number: | 9174472138 |
Fax Number: | |
NPI Enumeration Date: | 02/04/2014 |
NPI Last Update Date: | 03/13/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084A0401X |
License Number: | 12179 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | RI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Addiction Medicine |
Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |