MEDICARE: DR. MARY ALICE ELIZABETH 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	207R00000X	Internal Medicine Physician	MD.32084	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	LICENSE #: MD.32084	OTHER	AL	ALABAMA BOARD OF MEDICAL EXAMINERS
2	ACSC#: ACSC.32084	OTHER	AL	ALABAMA BOARD OF MEDICAL EXAMINERS

General Provider Information

NPI Number	:	1952694697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY ALICE ELIZABETH BAILEY M.D.

Provider Business Mailing Address
First Line	:	22720 BUCKSVILLE RD
Second Line	:
City	:	MC CALLA
State	:	AL
Zip	:	35111-2711
Country	:	US
Telephone Number	:	205-481-8640
Fax Number	:

Provider Business Practice Location Address
First Line	:	22720 BUCKSVILLE RD
Second Line	:
City	:	MC CALLA
State	:	AL
Zip	:	35111-2711
Country	:	US
Telephone Number	:	205-481-8640
Fax Number	:

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

Provider Enumeration Date	:	05/26/2011
Last Update Date	:	03/07/2023

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