=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609837079
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBERT WOODWARD BAILEY M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/28/2006
-----------------------------------------------------
Last Update Date | 10/09/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1881 PISGAH DRIVE BLDG. A
-----------------------------------------------------
City | HENDERSONVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28791-3760
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-697-4336
-----------------------------------------------------
Fax | 828-694-6757
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1869
-----------------------------------------------------
City | FLETCHER
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28732-1869
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-687-5616
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 30278
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------