Healthcare Provider Details

I. General information

NPI: 1851471486
Provider Name (Legal Business Name): JASON S. BAILEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 JESSE JEWELL PKWY NE STE 201
GAINESVILLE GA
30501-3822
US

IV. Provider business mailing address

1315 JESSE JEWELL PKWY NE
GAINESVILLE GA
30501-3811
US

V. Phone/Fax

Practice location:
  • Phone: 770-219-9300
  • Fax: 770-219-4965
Mailing address:
  • Phone: 770-219-9300
  • Fax: 770-219-4965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number051619
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number051619
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number51619
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: