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General NPI Number Information
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NPI Number | 1396730552
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Entity Type | Individual
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Provider Name | BILLY DEAN BAILEY MD
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Gender | Male
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Dates
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Enumeration Date | 09/14/2005
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Last Update Date | 06/07/2018
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Provider Practice Location Address
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Address Line | 125 AUGUSTA AVE SUITE A
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City | PADUCAH
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State | KY
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Zip | 42003-5515
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Country | US
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Telephone | 270-534-0046
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Fax | 270-534-0048
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Provider Business Mailing Address
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Address Line | 854 W. JAMES CAMPBELL BLVD SUITE 303
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City | COLUMBIA
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State | TN
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Zip | 38401
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Country | US
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Telephone | 931-388-9706
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Fax | 931-388-9772
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 26804
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 16622
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License Number State | TN
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