Healthcare Provider Details

I. General information

NPI: 1457331555
Provider Name (Legal Business Name): DEBRA R. BAILEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

238 CASSIDY BLVD
PIKEVILLE KY
41501-1426
US

IV. Provider business mailing address

PO BOX 432
PIKEVILLE KY
41502-0432
US

V. Phone/Fax

Practice location:
  • Phone: 606-430-2230
  • Fax: 606-437-2526
Mailing address:
  • Phone: 606-430-2230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number24703
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number24703
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: