Provider Demographics
NPI:1629366232
Name:BAILEY, JASON RAYMOND (DPM)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:RAYMOND
Last Name:BAILEY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:301 N 27TH ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-4401
Mailing Address - Country:US
Mailing Address - Phone:402-844-8158
Mailing Address - Fax:402-844-8159
Practice Address - Street 1:2701 W NORFOLK AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-4407
Practice Address - Country:US
Practice Address - Phone:402-844-8158
Practice Address - Fax:402-844-8159
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-17
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE344213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery