Provider Demographics
NPI:1093930927
Name:BAILEY FAMILY MEDICAL CARE PC
Entity Type:Organization
Organization Name:BAILEY FAMILY MEDICAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:T
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:480-860-5533
Mailing Address - Street 1:11390 E VIA LINDA STE 102
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-4075
Mailing Address - Country:US
Mailing Address - Phone:480-860-5533
Mailing Address - Fax:480-860-5005
Practice Address - Street 1:11390 E VIA LINDA STE 102
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85259-4075
Practice Address - Country:US
Practice Address - Phone:480-860-5533
Practice Address - Fax:480-860-5005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ27721207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ74977Medicare PIN