Healthcare Provider Details

I. General information

NPI: 1730870635
Provider Name (Legal Business Name): DAVID GREGORY BAILEY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2023
Last Update Date: 05/10/2025
Certification Date: 05/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 SAINT ELIZABETH BLVD STE 4000
O FALLON IL
62269-1284
US

IV. Provider business mailing address

31 SUNNEN DR APT 204
MAPLEWOOD MO
63143-3832
US

V. Phone/Fax

Practice location:
  • Phone: 618-233-5480
  • Fax:
Mailing address:
  • Phone: 214-801-8671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: