Provider Demographics
NPI:1427014273
Name:BAILEY, ROBERT T (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:T
Last Name:BAILEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:10715 N FRANK LLOYD WRIGHT BLVD
Mailing Address - Street 2:STE 107
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-2691
Mailing Address - Country:US
Mailing Address - Phone:480-860-5533
Mailing Address - Fax:480-860-5005
Practice Address - Street 1:10715 N FRANK LLOYD WRIGHT BLVD
Practice Address - Street 2:STE 107
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85259-2691
Practice Address - Country:US
Practice Address - Phone:480-860-5533
Practice Address - Fax:480-860-5005
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2019-02-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ27721207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZG45955Medicare UPIN
AZZ74978Medicare PIN