Provider Demographics
NPI:1669458782
Name:BAILEY, JAMES MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:MICHAEL
Last Name:BAILEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2971 GRAHAM RD
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-3619
Mailing Address - Country:US
Mailing Address - Phone:330-688-7981
Mailing Address - Fax:330-688-7469
Practice Address - Street 1:2971 GRAHAM RD
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-3619
Practice Address - Country:US
Practice Address - Phone:330-688-7981
Practice Address - Fax:330-688-7469
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35069285207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH080119563OtherRAILROAD MEDICARE
OH2044219Medicaid
OH2044219Medicaid
G63946Medicare UPIN