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General NPI Number Information
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NPI Number | 1275738486
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Entity Type | Individual
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Provider Name | JASON M BAILEY D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 1165 N BUTTERFIELD RD
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City | BOLIVAR
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State | MO
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Zip | 65613-1056
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Country | US
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Telephone | 417-328-6055
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Fax | 417-328-6632
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Provider Business Mailing Address
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Address Line | 1500 N OAKLAND AVE
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City | BOLIVAR
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State | MO
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Zip | 65613-3011
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Country | US
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Telephone | 620-704-4745
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Fax | 417-328-6632
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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 | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 2025006913
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 05-36693
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 05-36693
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License Number State | KS
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