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General NPI Number Information
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NPI Number | 1124311121
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Entity Type | Organization
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Legal Business Name | WM KEVIN BAILEY MD PC
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Dates
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Enumeration Date | 05/24/2011
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Last Update Date | 05/25/2011
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Provider Practice Location Address
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Address Line | 112 HOTEL RD
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City | KNOXVILLE
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State | TN
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Zip | 37918-3224
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Country | US
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Telephone | 865-689-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 112 HOTEL RD
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City | KNOXVILLE
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State | TN
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Zip | 37918-3224
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM BAILEY
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Credential |
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Telephone | 865-689-4500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | MD0000020443
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License Number State | TN
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