Provider Demographics
NPI:1457865016
Name:BAILEY, ALEXANDER VAUGHN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:VAUGHN
Last Name:BAILEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8827 KAK ISLAND ST
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-8553
Mailing Address - Country:US
Mailing Address - Phone:276-202-5531
Mailing Address - Fax:
Practice Address - Street 1:12051 OLD GLENN HWY
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7736
Practice Address - Country:US
Practice Address - Phone:276-202-5531
Practice Address - Fax:276-202-5531
Is Sole Proprietor?:No
Enumeration Date:2017-11-18
Last Update Date:2017-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK125961183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist