Healthcare Provider Details

I. General information

NPI: 1285772160
Provider Name (Legal Business Name): ANDREW KEITH BAILEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 STANTON L YOUNG BLVD
OKLAHOMA CITY OK
73104
US

IV. Provider business mailing address

608 STANTON L YOUNG BLVD
OKLAHOMA CITY OK
73104-5014
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-6060
  • Fax: 405-271-3013
Mailing address:
  • Phone: 405-271-6060
  • Fax: 405-271-3013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number2005-01293
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number27694
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License Number27694
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: