Provider Demographics
NPI:1477532562
Name:BAILEY, ANTHONY DOUGLAS (OD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:DOUGLAS
Last Name:BAILEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4521 CHADWICK RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-7958
Mailing Address - Country:US
Mailing Address - Phone:319-266-1136
Mailing Address - Fax:319-277-2326
Practice Address - Street 1:4521 CHADWICK RD
Practice Address - Street 2:SUITE 1
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-7958
Practice Address - Country:US
Practice Address - Phone:319-266-1136
Practice Address - Fax:319-277-2326
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-17
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1970152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA08925Medicare ID - Type Unspecified