Provider Demographics
NPI:1245207877
Name:BAILLIO, EMILY RENE (MD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:RENE
Last Name:BAILLIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:832 PRINCETON AVE SW
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35211-1320
Mailing Address - Country:US
Mailing Address - Phone:205-397-8924
Mailing Address - Fax:205-206-8363
Practice Address - Street 1:832 PRINCETON AVE SW
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-1320
Practice Address - Country:US
Practice Address - Phone:205-397-8924
Practice Address - Fax:205-206-8363
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00016593207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL199147Medicaid
AL511-89344OtherBCBS OF AL
AL051501004OtherBLUE SHIELD
AL051501005OtherBLUE SHIELD
ALG591OtherMEDICARE GROUP PAYEE NUMBER
AL051501002OtherBLUE SHIELD
AL303709369Medicaid
AL303799369Medicaid
ALG590OtherMEDICARE GROUP PAYEE NUMBER
AL051500996OtherBLUE SHIELD
AL303749369Medicaid
AL303769369Medicaid
AL303719369Medicaid
ALD074OtherMEDICARE GROUP NUMBER
ALG588OtherMEDICARE GROUP PAYEE NUMBER
ALG587OtherMEDICARE GOUP PAYEE NUMBR
AL051500999OtherBLUE SHIELD
AL303729369Medicaid
ALG592OtherMEDICARE GROUP PAYEE NUMBER
AL051500998OtherBLUE SHIELD
AL303739369Medicaid
ALG586OtherMEDICARE GROUP PAYEE NUMBER
ALF29542Medicare UPIN