Provider Demographics
NPI:1518041813
Name:ANTHONY D BAILEY OD PC
Entity Type:Organization
Organization Name:ANTHONY D BAILEY OD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:319-266-1136
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1970152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA08925Medicare ID - Type Unspecified
IAU33534Medicare UPIN
IA4348460001Medicare NSC