Healthcare Provider Details

I. General information

NPI: 1114074101
Provider Name (Legal Business Name): GREGORY J BAILEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 03/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6440 W NEWBERRY RD #409
GAINESVILLE FL
32605-4381
US

IV. Provider business mailing address

6440 W NEWBERRY RD #409
GAINESVILLE FL
32605-4381
US

V. Phone/Fax

Practice location:
  • Phone: 352-333-6161
  • Fax: 352-333-6162
Mailing address:
  • Phone: 352-333-6161
  • Fax: 352-333-6162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberME57518
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: