Healthcare Provider Details

I. General information

NPI: 1649598509
Provider Name (Legal Business Name): CHRISTINE BAILEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2010
Last Update Date: 08/10/2021
Certification Date: 08/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N ELM ST STE 6572
GREENSBORO NC
27401-1004
US

IV. Provider business mailing address

PO BOX 909
LOUISVILLE KY
40201-0909
US

V. Phone/Fax

Practice location:
  • Phone: 336-832-6160
  • Fax:
Mailing address:
  • Phone: 502-629-6000
  • Fax: 502-629-5865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number49523
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number49523
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: