MEDICARE: BAILEY NEASBY

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1992667554
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BAILEY NEASBY

Provider Business Mailing Address
First Line	:	9934 E 115TH ST S
Second Line	:
City	:	BIXBY
State	:	OK
Zip	:	74008-2244
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5310 E 31ST ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74135-5012
Country	:	US
Telephone Number	:	918-587-9471
Fax Number	:

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

Provider Enumeration Date	:	12/02/2025
Last Update Date	:	12/02/2025

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Directions to “ BAILEY NEASBY ” Practice Location

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