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NPI Code Detail

MEDICARE: ROBERT L BAILEY PHD HSPP

MEDICARE: ROBERT L BAILEY PHD HSPP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist20090232AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144289323
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT L BAILEY PHD HSPP
Provider Business Mailing Address
First Line : 645 S ROGERS ST
Second Line :
City : BLOOMINGTON
State : IN
Zip : 47403-2353
Country : US
Telephone Number : 812-339-1691
Fax Number : 812-337-2438
Provider Business Practice Location Address
First Line : 831 DILLON DR
Second Line :
City : RICHMOND
State : IN
Zip : 47374-8048
Country : US
Telephone Number : 765-983-8000
Fax Number : 765-935-3869
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2006
Last Update Date : 07/02/2014

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Directions to “ ROBERT L BAILEY PHD HSPP” Practice Location

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