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General NPI Number Information
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NPI Number | 1346946654
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Entity Type | Organization
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Legal Business Name | BAILEY PRIMARY CARE LLC
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Dates
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Enumeration Date | 02/07/2023
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Last Update Date | 02/07/2023
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Provider Practice Location Address
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Address Line | 109B PROFESSIONAL PLZ
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City | HELENA
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State | AR
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Zip | 72342-8954
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Country | US
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Telephone | 870-228-1480
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Fax | 870-228-1475
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Provider Business Mailing Address
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Address Line | PO BOX 2660
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City | WEST HELENA
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State | AR
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Zip | 72390-0660
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Country | US
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Telephone | 870-228-1480
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Fax | 870-228-1475
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | THOMAS O BAILEY
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Credential | MD
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Telephone | 870-228-1480
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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 |
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License Number State |
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