Provider Demographics
NPI:1316577521
Name:BAILEY, HASSELL ALLAN (JD)
Entity Type:Individual
Prefix:
First Name:HASSELL
Middle Name:ALLAN
Last Name:BAILEY
Suffix:
Gender:M
Credentials:JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10950 SLATE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:GRUNDY
Mailing Address - State:VA
Mailing Address - Zip Code:24614-7432
Mailing Address - Country:US
Mailing Address - Phone:276-259-7671
Mailing Address - Fax:
Practice Address - Street 1:10950 SLATE CREEK RD
Practice Address - Street 2:
Practice Address - City:GRUNDY
Practice Address - State:VA
Practice Address - Zip Code:24614-7432
Practice Address - Country:US
Practice Address - Phone:276-259-7671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-16
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)