Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | MD176550 | OR |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | MD176550 | OR |
NPI | 1902258080 |
---|---|
Provider Name | Dr. Gillian Bayley |
First Address | Klamath Falls, OR 97601-1121 |
Second Address | Klamath Falls, OR 97601-1121 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2016 |
Last Update Date | 13/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
500714982 | (05) | OR |
P0177473 | RAIL ROAD MEDICARE (01) | OR |