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NPI Code Detail

MEDICARE: DR. JASON S. BAILEY P.C.

MEDICARE: DR. JASON S. BAILEY P.C.
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
1152W00000XOptometristSC1322SC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00298650OTHERSCRAILROAD MEDICARE

General Provider Information

NPI Number : 1609058783
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR. JASON S. BAILEY P.C.
Provider Business Mailing Address
First Line : 33 KEMMERLIN LANE
Second Line :
City : BEAUFORT
State : SC
Zip : 29907-2702
Country : US
Telephone Number : 843-521-2020
Fax Number : 843-524-7559
Provider Business Practice Location Address
First Line : 33 KEMMERLIN LANE
Second Line :
City : BEAUFORT
State : SC
Zip : 29907-2702
Country : US
Telephone Number : 843-521-2020
Fax Number : 843-524-7559
Authorized Official
Title or Position : OWNER
Name : DR. JASON S BAILEY
Credential :
Telephone Number : 843-521-2020
Provider Enumeration Date : 11/30/2007
Last Update Date : 04/24/2009

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Directions to “DR. JASON S. BAILEY P.C. ” Practice Location

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