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NPI Code Detail

MEDICARE: JOHN RUSSELL BAILEY MD

MEDICARE:   JOHN RUSSELL 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
1207R00000XInternal Medicine Physician35578NC
2207RI0011XInterventional Cardiology Physician35578NC
3207RC0001XClinical Cardiac Electrophysiology Physician35578NC

Other Identifiers

General Provider Information

NPI Number : 1891793121
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN RUSSELL BAILEY MD
Provider Business Mailing Address
First Line : PO BOX 60447
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-0447
Country : US
Telephone Number : 704-343-9800
Fax Number : 704-347-2011
Provider Business Practice Location Address
First Line : 125 QUEENS RD STE 200
Second Line :
City : CHARLOTTE
State : NC
Zip : 28204-3578
Country : US
Telephone Number : 704-343-9800
Fax Number : 704-347-2011
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2005
Last Update Date : 07/21/2023

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Directions to “ JOHN RUSSELL BAILEY MD” Practice Location

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