Provider Demographics
NPI:1114912540
Name:HARRIS-BAUGH, SHARON Y (MD)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:Y
Last Name:HARRIS-BAUGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 CAISSON HILL RD
Mailing Address - Street 2:
Mailing Address - City:FT RILEY
Mailing Address - State:KS
Mailing Address - Zip Code:66442-7037
Mailing Address - Country:US
Mailing Address - Phone:785-239-7794
Mailing Address - Fax:785-239-7240
Practice Address - Street 1:600 CAISSON HILL RD
Practice Address - Street 2:
Practice Address - City:FT RILEY
Practice Address - State:KS
Practice Address - Zip Code:66442-7037
Practice Address - Country:US
Practice Address - Phone:785-239-7794
Practice Address - Fax:785-239-7240
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR3M88207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO208203109Medicaid
KS100457230AMedicaid
KS100457230AMedicaid
MOP611660Medicare PIN
MOE45686Medicare UPIN
MOP611660Medicare ID - Type Unspecified