Provider Demographics
NPI:1487680567
Name:BAILEY, IEVA (MD)
Entity Type:Individual
Prefix:
First Name:IEVA
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 12TH AVE N
Mailing Address - Street 2:STE 230W
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-7506
Mailing Address - Country:US
Mailing Address - Phone:406-238-6010
Mailing Address - Fax:406-238-6022
Practice Address - Street 1:2900 12TH AVE N
Practice Address - Street 2:STE 230W
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-7506
Practice Address - Country:US
Practice Address - Phone:406-238-6010
Practice Address - Fax:406-238-6022
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT7790207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0065943Medicaid
MT95515OtherBLUE CROSS OF MONTANA
MT211161010402OtherPREFERRED ONE
MT45155207OtherWAUSAU
MT211161010402OtherPREFERRED ONE
MT0065943Medicaid