Provider Demographics
NPI:1912544669
Name:CHITWOOD, BAILEY (PA-C)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:
Last Name:CHITWOOD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 CHICKASAW LN
Mailing Address - Street 2:
Mailing Address - City:LOUDON
Mailing Address - State:TN
Mailing Address - Zip Code:37774-2159
Mailing Address - Country:US
Mailing Address - Phone:865-323-2615
Mailing Address - Fax:
Practice Address - Street 1:1574 MEDICAL CENTER PKWY STE 104
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-3761
Practice Address - Country:US
Practice Address - Phone:615-225-2070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-02
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3972363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant