Healthcare Provider Details

I. General information

NPI: 1346850856
Provider Name (Legal Business Name): CHRISTOPHER LEE BAILEY EMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2020
Last Update Date: 11/27/2023
Certification Date: 08/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1893 LATHROP ST SE
ATLANTA GA
30315-6917
US

IV. Provider business mailing address

1893 LATHROP ST SE
ATLANTA GA
30315-6917
US

V. Phone/Fax

Practice location:
  • Phone: 678-650-7466
  • Fax:
Mailing address:
  • Phone: 678-650-7466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146M00000X
TaxonomyIntermediate Emergency Medical Technician
License NumberIO44926
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: