MEDICARE: PAUL BAILEY MD

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	2085R0202X	Diagnostic Radiology Physician	71031	CT
2	2085R0202X	Diagnostic Radiology Physician	C0684	KY
3	2085R0202X	Diagnostic Radiology Physician	2838	MD

General Provider Information

NPI Number	:	1841428463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL BAILEY MD

Provider Business Mailing Address
First Line	:	2825 OAK LAWN AVE UNIT 192749
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75219-4688
Country	:	US
Telephone Number	:	510-683-9500
Fax Number	:	877-880-2039

Provider Business Practice Location Address
First Line	:	7148 AMBASSADOR RD
Second Line	:
City	:	WINDSOR MILL
State	:	MD
Zip	:	21244-2707
Country	:	US
Telephone Number	:	443-436-1221
Fax Number	:

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

Provider Enumeration Date	:	06/23/2009
Last Update Date	:	09/10/2024

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