Provider Demographics
NPI:1164788030
Name:BAILEY, WILLIAM SCOTT (RPH)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:SCOTT
Last Name:BAILEY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:MR
Other - First Name:WILLIAM
Other - Middle Name:SCOTT
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:1883 WENTZVILLE PARKWAY
Mailing Address - Street 2:2345
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385
Mailing Address - Country:US
Mailing Address - Phone:636-639-7414
Mailing Address - Fax:
Practice Address - Street 1:1883 WENTZVILLE PARKWAY
Practice Address - Street 2:2345
Practice Address - City:WENTZVILLE
Practice Address - State:MO
Practice Address - Zip Code:63385
Practice Address - Country:US
Practice Address - Phone:636-639-7434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-05
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005018139183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist