Provider Demographics
NPI:1013204734
Name:BAILEY, JOANNA MARIE ADKINS (MD)
Entity Type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:MARIE ADKINS
Last Name:BAILEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JOANNA
Other - Middle Name:MARIE
Other - Last Name:ADKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 430
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:24874-0430
Mailing Address - Country:US
Mailing Address - Phone:304-732-7069
Mailing Address - Fax:304-732-7098
Practice Address - Street 1:585 APPALACHIAN HIGHWAY
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:WV
Practice Address - Zip Code:24874-0430
Practice Address - Country:US
Practice Address - Phone:304-598-6900
Practice Address - Fax:304-732-7098
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV25206207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVWV4546CMedicare PIN
WVWV4546BMedicare PIN
WVWV4546AMedicare PIN