Provider Demographics
NPI:1942492426
Name:BAILEY, ZACHARY MAX (MD)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:MAX
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 1:180 FORD RD
Mailing Address - Street 2:
Mailing Address - City:JOHN DAY
Mailing Address - State:OR
Mailing Address - Zip Code:97845-1088
Mailing Address - Country:US
Mailing Address - Phone:541-575-0404
Mailing Address - Fax:541-575-1124
Practice Address - Street 1:180 FORD RD
Practice Address - Street 2:
Practice Address - City:JOHN DAY
Practice Address - State:OR
Practice Address - Zip Code:97845-1088
Practice Address - Country:US
Practice Address - Phone:541-575-0404
Practice Address - Fax:541-575-1124
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5010711205207Q00000X
ORMD29025207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500614152Medicaid
000061335Medicare PIN
000061337Medicare PIN
000063149Medicare PIN
OR500614152Medicaid
000061338Medicare PIN