Basic Information
| Provider Information | |||||||||
| NPI: | 1992870331 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BAYLESS | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | MARSHALL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 SOUTH ARLINGTON AVENUE | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895012002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7753481900 | ||||||||
| FaxNumber: | 7753481904 | ||||||||
| Practice Location | |||||||||
| Address1: | 235 W 6TH ST | ||||||||
| Address2: | SAINT MARY'S REGIONAL MEDICAL CENTER | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895034548 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7757703000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/21/2006 | ||||||||
| LastUpdateDate: | 10/05/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 4608 | NV | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 002016662 | 05 | NV | MEDICAID |