Provider Demographics
NPI:1275602070
Name:BAILEY, CHRISTOPHER M (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:M
Last Name:BAILEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1810
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-1080
Mailing Address - Country:US
Mailing Address - Phone:606-886-3831
Mailing Address - Fax:606-886-9980
Practice Address - Street 1:400 UNIVERSITY DR
Practice Address - Street 2:SUITE 101-A
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-1080
Practice Address - Country:US
Practice Address - Phone:606-886-3831
Practice Address - Fax:606-886-3440
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2017-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY02799207QA0401X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64061336Medicaid
093202Medicare ID - Type Unspecified
KY64061336Medicaid