MEDICARE: MS. MOLLIE GEORGETTE BAILEY PA

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	363A00000X	Physician Assistant	PA.0003978	CO

Other Identifiers

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

General Provider Information

NPI Number	:	1841270055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MOLLIE GEORGETTE BAILEY PA

Provider Business Mailing Address
First Line	:	7495 W 29TH AVE
Second Line	:
City	:	WHEAT RIDGE
State	:	CO
Zip	:	80033-8002
Country	:	US
Telephone Number	:	303-360-6276
Fax Number	:	303-761-2787

Provider Business Practice Location Address
First Line	:	3981 S RESERVOIR RD UNIT A
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80013-3804
Country	:	US
Telephone Number	:	303-761-1977
Fax Number	:	303-789-7222

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

Provider Enumeration Date	:	01/23/2006
Last Update Date	:	10/16/2023

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