Provider Demographics
NPI:1144742453
Name:BAILEY, DAVID THOMAS
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:THOMAS
Last Name:BAILEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5505 CEDARSHED CV
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-3444
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:UNIV. OF S. ALABAMA DEPT. OF PA STUDIES
Practice Address - Street 2:5721 USA DRIVE NORTH - HAHN 3124
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36688
Practice Address - Country:US
Practice Address - Phone:251-445-9334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-10
Last Update Date:2017-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant