Provider Demographics
NPI:1295853703
Name:HUGH BAILEY MD LLC
Entity Type:Organization
Organization Name:HUGH BAILEY MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER, LLC
Authorized Official - Prefix:DR
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-781-9695
Mailing Address - Street 1:124 WESTWOODS DR
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-1181
Mailing Address - Country:US
Mailing Address - Phone:816-781-9695
Mailing Address - Fax:816-781-9047
Practice Address - Street 1:124 WESTWOODS DR
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-1181
Practice Address - Country:US
Practice Address - Phone:816-781-9695
Practice Address - Fax:816-781-9047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR5302207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1093710923OtherTYPE I NPI HUGH BAILEY
MO1093710923OtherTYPE I NPI HUGH BAILEY
MOC50965Medicare UPIN