=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518961853
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROYCE K BAILEY MD, MPH
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/01/2005
-----------------------------------------------------
Last Update Date | 12/06/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 50 HOSPITAL DR STE 1D
-----------------------------------------------------
City | HENDERSONVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28792-5248
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-684-2234
-----------------------------------------------------
Fax | 828-209-5338
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1869
-----------------------------------------------------
City | FLETCHER
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28732-1869
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-687-5616
-----------------------------------------------------
Fax | 828-650-8076
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | 31429
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 31429
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------