Healthcare Provider Details
I. General information
NPI: 1659338663
Provider Name (Legal Business Name): JAMES E BAILEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/26/2006
Last Update Date: 08/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1910 NONCONNAH BLVD SUITE 120
MEMPHIS TN
38132-2113
US
IV. Provider business mailing address
66 N PAULINE ST SUITE 206
MEMPHIS TN
38105-5105
US
V. Phone/Fax
- Phone: 901-448-2300
- Fax: 901-448-6657
- Phone: 901-448-7642
- Fax: 901-448-8015
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 26147 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: