MEDICARE: DR. KIMBERLY JOY BAILEY-SHAW DC

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	111N00000X	Chiropractor	770	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	B0244	OTHER	ANTHEM
2	M66170	OTHER	HEALTHSURCE
3	015552	OTHER	BCBS
4	ME0048	OTHER	HARVARD PILGRIM
5	350034518	OTHER	RR M'CARE

General Provider Information

NPI Number	:	1861500266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIMBERLY JOY BAILEY-SHAW DC

Provider Business Mailing Address
First Line	:	PO BOX 8120
Second Line	:
City	:	WINSLOW
State	:	ME
Zip	:	04901-8120
Country	:	US
Telephone Number	:	207-873-5161
Fax Number	:	207-873-5163

Provider Business Practice Location Address
First Line	:	138 HALIFAX ST
Second Line	:
City	:	WINSLOW
State	:	ME
Zip	:	04901
Country	:	US
Telephone Number	:	207-873-5161
Fax Number	:	207-873-5163

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

Provider Enumeration Date	:	08/26/2006
Last Update Date	:	11/26/2012

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Directions to “ DR. KIMBERLY JOY BAILEY-SHAW DC” Practice Location

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