Provider Demographics
NPI:1164661641
Name:BAILEY, MICHAEL TROY (CRNA)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:TROY
Last Name:BAILEY
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 CHILDRENS DR
Mailing Address - Street 2:CHILDREN'S ANESTHESIA ASSOCIATES, INC
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2664
Mailing Address - Country:US
Mailing Address - Phone:614-722-4200
Mailing Address - Fax:614-722-4203
Practice Address - Street 1:700 CHILDRENS DR
Practice Address - Street 2:CHILDREN'S ANESTHESIA ASSOCIATES, INC
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2664
Practice Address - Country:US
Practice Address - Phone:614-722-4200
Practice Address - Fax:614-722-4203
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-06
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA10491-NA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCOA10491-NAOtherOHIO LICENSE