Provider Demographics
NPI:1760556740
Name:BAILEY, NORMAN J (DC)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:J
Last Name:BAILEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 SYCAMORE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18966-4272
Mailing Address - Country:US
Mailing Address - Phone:215-355-2455
Mailing Address - Fax:215-355-2737
Practice Address - Street 1:820 SYCAMORE DR
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-4272
Practice Address - Country:US
Practice Address - Phone:215-355-2455
Practice Address - Fax:215-355-2737
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC001116L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7743883OtherAETNA
PA0023306000OtherHMO ID
PAU-24402Medicare UPIN