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General NPI Number Information
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NPI Number | 1538790027
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Entity Type | Individual
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Provider Name | ASHLEY BAILES
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Gender | Female
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Dates
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Enumeration Date | 02/03/2020
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Last Update Date | 02/03/2020
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Provider Practice Location Address
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Address Line | 15234 GREENFIELD DRIVE
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City | ATHENS
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State | AL
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Zip | 35613
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Country | US
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Telephone | 256-771-0994
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Fax |
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Provider Business Mailing Address
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Address Line | 20441 PHEASANT DR
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City | ATHENS
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State | AL
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Zip | 35613-4943
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 1-131319
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License Number State | AL
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