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NPI Code Detail

MEDICARE: MR. ROBERT BLAIR BAILEY

MEDICARE:  MR. ROBERT BLAIR BAILEY
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
11744P3200XProsthetics Case Management112590-60-001AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
148390OTHERARBC/BS

General Provider Information

NPI Number : 1316963416
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT BLAIR BAILEY
Provider Business Mailing Address
First Line : 7635 COUNTS MASSIE RD
Second Line :
City : NORTH LITTLE ROCK
State : AR
Zip : 72113-6656
Country : US
Telephone Number : 501-224-0330
Fax Number : 501-224-0356
Provider Business Practice Location Address
First Line : 7635 COUNTS MASSIE RD
Second Line :
City : NORTH LITTLE ROCK
State : AR
Zip : 72113-6656
Country : US
Telephone Number : 501-224-0330
Fax Number : 501-224-0356
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2006
Last Update Date : 07/09/2007

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Directions to “ MR. ROBERT BLAIR BAILEY ” Practice Location

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