Provider Demographics
NPI:1801850995
Name:BAILEY, SHELBY KINT (MD)
Entity Type:Individual
Prefix:DR
First Name:SHELBY
Middle Name:KINT
Last Name:BAILEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8075 MADISON BLVD
Mailing Address - Street 2:STE 112
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-2042
Mailing Address - Country:US
Mailing Address - Phone:256-772-6018
Mailing Address - Fax:256-772-7909
Practice Address - Street 1:501 E DR HICKS BLVD STE A
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-5742
Practice Address - Country:US
Practice Address - Phone:256-383-0423
Practice Address - Fax:256-383-0922
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL00011545208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051556654Medicaid
AL051556654Medicaid
AL051556654Medicare PIN