Healthcare Provider Details

I. General information

NPI: 1487680567
Provider Name (Legal Business Name): IEVA BAILEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 12TH AVE N STE 230W
BILLINGS MT
59101-7506
US

IV. Provider business mailing address

2900 12TH AVE N STE 230W
BILLINGS MT
59101-7506
US

V. Phone/Fax

Practice location:
  • Phone: 406-238-6010
  • Fax: 406-238-6022
Mailing address:
  • Phone: 406-238-6010
  • Fax: 406-238-6022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number7790
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: