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General NPI Number Information
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NPI Number | 1235126582
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Entity Type | Individual
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Provider Name | JIMMIE DALE BAILEY II MD
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Gender | Male
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Dates
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Enumeration Date | 10/03/2005
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Last Update Date | 06/27/2022
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Provider Practice Location Address
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Address Line | 1001 E JOHNSON ST
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City | HOLYOKE
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State | CO
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Zip | 80734-1854
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Country | US
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Telephone | 970-854-2500
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Fax | 970-854-3887
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Provider Business Mailing Address
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Address Line | 1001 E JOHNSON ST
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City | HOLYOKE
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State | CO
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Zip | 80734-1854
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Country | US
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Telephone | 970-854-2500
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Fax | 970-854-3887
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD. 22758
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DR.0065419
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME 125949
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License Number State | FL
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