MEDICARE: BRIAN MARCUS BAILEY M.D.

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
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	057930	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	057930	OTHER	GA	GEORGIA MEDICAL LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609801810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN MARCUS BAILEY M.D.

Provider Business Mailing Address
First Line	:	602 E 72ND ST
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31405-4913
Country	:	US
Telephone Number	:	912-819-7878
Fax Number	:	912-819-7850

Provider Business Practice Location Address
First Line	:	5354 REYNOLDS ST STE 102
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31405-6008
Country	:	US
Telephone Number	:	912-819-0500
Fax Number	:	912-819-0501

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	03/17/2018

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