Provider Demographics
NPI:1699035493
Name:STEVEN P BAILEY D.C, P.C
Entity Type:Organization
Organization Name:STEVEN P BAILEY D.C, P.C
Other - Org Name:ST BETHLEHEM CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:931-645-9768
Mailing Address - Street 1:2121 WILMA RUDOLPH BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-6877
Mailing Address - Country:US
Mailing Address - Phone:931-645-9768
Mailing Address - Fax:931-647-5975
Practice Address - Street 1:2121 WILMA RUDOLPH BLVD STE A
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-6877
Practice Address - Country:US
Practice Address - Phone:931-645-9768
Practice Address - Fax:931-647-5975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-25
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000000460111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103G708235Medicare Oscar/Certification