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NPI Code Detail

MEDICARE: ROGER D. BAILEY DC PLLC

MEDICARE: ROGER D. BAILEY DC PLLC
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
1111N00000XChiropractor325TN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3DF6318OTHERTNRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
16143906OTHERTNCIGNA HEALTHCARE
24053304OTHERTNBCBS

General Provider Information

NPI Number : 1154525863
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROGER D. BAILEY DC PLLC
Provider Business Mailing Address
First Line : 1119 E COLLEGE ST
Second Line : SUITE 4
City : PULASKI
State : TN
Zip : 38478-4563
Country : US
Telephone Number : 931-424-3331
Fax Number : 931-363-9777
Provider Business Practice Location Address
First Line : 1119 E COLLEGE ST
Second Line : SUITE 4
City : PULASKI
State : TN
Zip : 38478-4563
Country : US
Telephone Number : 931-424-3331
Fax Number : 931-363-9777
Authorized Official
Title or Position : OWNER
Name : DR. ROGER D. BAILEY
Credential : D.C.
Telephone Number : 931-424-3331
Provider Enumeration Date : 06/14/2007
Last Update Date : 08/22/2020

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