Provider Demographics
NPI:1487631099
Name:BAILIE, DAVID S (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:S
Last Name:BAILIE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9375 E SHEA BLVD
Mailing Address - Street 2:STE 263
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260
Mailing Address - Country:US
Mailing Address - Phone:480-264-6995
Mailing Address - Fax:844-574-8199
Practice Address - Street 1:20401 N 73RD ST
Practice Address - Street 2:STE 155
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-4107
Practice Address - Country:US
Practice Address - Phone:480-264-6995
Practice Address - Fax:844-574-8199
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2015-12-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ23831207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ343301Medicaid
1265803605OtherGROUP NPI
G13423Medicare UPIN
AZ343301Medicaid