Provider Demographics
NPI:1477553543
Name:BAILEY, RICHARD LEFROY (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LEFROY
Last Name:BAILEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 21944
Mailing Address - Street 2:
Mailing Address - City:BULLHEAD CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86439-1944
Mailing Address - Country:US
Mailing Address - Phone:928-763-1020
Mailing Address - Fax:928-763-2076
Practice Address - Street 1:3750 HWY 95
Practice Address - Street 2:SUITE 101
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442-6050
Practice Address - Country:US
Practice Address - Phone:928-763-1020
Practice Address - Fax:928-763-2076
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ25327207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZG55860Medicare UPIN
AZZ121434Medicare PIN