Healthcare Provider Details

I. General information

NPI: 1003173790
Provider Name (Legal Business Name): WILLIAM ALAN BAILEY PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2012
Last Update Date: 04/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 OAK GROVE ST
MOUNTAIN VIEW AR
72560-8601
US

IV. Provider business mailing address

160 CAMP RD
LOCUST GROVE AR
72550-9547
US

V. Phone/Fax

Practice location:
  • Phone: 870-269-7059
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License NumberPT 3224
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: