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General NPI Number Information
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NPI Number | 1093703415
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Entity Type | Individual
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Provider Name | ERIC SCOTT BAILEY O.D.
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Gender | Male
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Dates
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Enumeration Date | 10/10/2005
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Last Update Date | 12/15/2020
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Provider Practice Location Address
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Address Line | 1447 E 7TH ST
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City | MONTICELLO
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State | MN
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Zip | 55362-4666
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Country | US
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Telephone | 763-295-5600
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Fax | 888-785-9518
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Provider Business Mailing Address
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Address Line | 2416 MEADOW DR
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City | BUFFALO
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State | MN
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Zip | 55313-2424
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Country | US
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Telephone | 320-250-6254
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Fax | 888-785-9518
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2232
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License Number State | MN
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