Provider Demographics
NPI:1265458798
Name:BAILEY, ERROLL J (MD)
Entity Type:Individual
Prefix:DR
First Name:ERROLL
Middle Name:J
Last Name:BAILEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:550 PEACHTREE ST NE
Mailing Address - Street 2:19TH FLOOR
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2247
Mailing Address - Country:US
Mailing Address - Phone:404-215-2000
Mailing Address - Fax:404-215-2001
Practice Address - Street 1:550 PEACHTREE ST NE
Practice Address - Street 2:19TH FLOOR
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2247
Practice Address - Country:US
Practice Address - Phone:404-215-2000
Practice Address - Fax:404-215-2001
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA034768207XX0004X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000466199EMedicaid
GA000466199FMedicaid
GA000466199HMedicaid
GA000466199GMedicaid
GA000466199EMedicaid
GA000466199FMedicaid