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General NPI Number Information
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NPI Number | 1265243315
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Entity Type | Individual
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Provider Name | PEYTON RANDOLPH BAILEY PA-C
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Gender | Male
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Dates
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Enumeration Date | 01/17/2025
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 215 ROANOKE ST
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City | CHRISTIANSBURG
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State | VA
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Zip | 24073-3025
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Country | US
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Telephone | 540-381-0820
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Fax |
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Provider Business Mailing Address
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Address Line | 495 STAFFORD DR
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City | CHRISTIANSBURG
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State | VA
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Zip | 24073-1035
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Country | US
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Telephone | 540-250-0159
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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