Provider Demographics
NPI:1467761460
Name:BAILEY, THOMAS EDWIN (THOMAS E BAILEY MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:EDWIN
Last Name:BAILEY
Suffix:
Gender:M
Credentials:THOMAS E BAILEY MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2642 S 1050 W
Mailing Address - Street 2:
Mailing Address - City:LYONS
Mailing Address - State:IN
Mailing Address - Zip Code:47443-7021
Mailing Address - Country:US
Mailing Address - Phone:812-659-3341
Mailing Address - Fax:
Practice Address - Street 1:2642 S 1050 W
Practice Address - Street 2:
Practice Address - City:LYONS
Practice Address - State:IN
Practice Address - Zip Code:47443-7021
Practice Address - Country:US
Practice Address - Phone:812-659-3341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-26
Last Update Date:2010-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01021424B2086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care