Healthcare Provider Details

I. General information

NPI: 1073449765
Provider Name (Legal Business Name): BAILEY HAMM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 ALABAMA RD
ADEL GA
31620-3818
US

IV. Provider business mailing address

502 S HUTCHINSON AVE
ADEL GA
31620-3510
US

V. Phone/Fax

Practice location:
  • Phone: 229-896-9994
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: