Provider Demographics
NPI:1639350101
Name:G.VINCENT BAILEY, M.D. (APMC)
Entity Type:Organization
Organization Name:G.VINCENT BAILEY, M.D. (APMC)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:G.
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-824-6150
Mailing Address - Street 1:1914 JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:JENNINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70546-3628
Mailing Address - Country:US
Mailing Address - Phone:337-824-6150
Mailing Address - Fax:337-824-6152
Practice Address - Street 1:1914 JOHNSON ST
Practice Address - Street 2:
Practice Address - City:JENNINGS
Practice Address - State:LA
Practice Address - Zip Code:70546-3628
Practice Address - Country:US
Practice Address - Phone:337-824-6150
Practice Address - Fax:337-824-6152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-26
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA016806207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1949141Medicaid
LA5C496OtherMEDICARE
LA5C496OtherMEDICARE