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NPI Code Detail

MEDICARE: DR. ERICA LOUISE BAILEY OD

MEDICARE: DR. ERICA LOUISE BAILEY OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristOPT003389GA
2152W00000XOptometrist3723TN
3152W00000XOptometristATI4538OR
4152W00000XOptometrist011085NY

General Provider Information

NPI Number : 1790396471
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ERICA LOUISE BAILEY OD
Provider Business Mailing Address
First Line : 6117 OOLTEWAH GEORGETOWN RD STE 109
Second Line :
City : OOLTEWAH
State : TN
Zip : 37363-5611
Country : US
Telephone Number : 423-238-3290
Fax Number :
Provider Business Practice Location Address
First Line : 6117 OOLTEWAH GEORGETOWN RD STE 109
Second Line :
City : OOLTEWAH
State : TN
Zip : 37363-5611
Country : US
Telephone Number : 423-238-3290
Fax Number : 423-238-3439
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2020
Last Update Date : 04/23/2026

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