Provider Demographics
NPI:1528540358
Name:DR. BAILEY PEARSON, OD, PLLC
Entity Type:Organization
Organization Name:DR. BAILEY PEARSON, OD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BAILEY
Authorized Official - Middle Name:ELISE
Authorized Official - Last Name:PEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:989-619-6473
Mailing Address - Street 1:PO BOX 1220
Mailing Address - Street 2:
Mailing Address - City:GAYLORD
Mailing Address - State:MI
Mailing Address - Zip Code:49734-5220
Mailing Address - Country:US
Mailing Address - Phone:989-705-1255
Mailing Address - Fax:
Practice Address - Street 1:713 S WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735-1766
Practice Address - Country:US
Practice Address - Phone:989-705-1255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901005116152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty