Provider Demographics
NPI:1184615023
Name:BAILEY, JOAN FRANCES (MD)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:FRANCES
Last Name:BAILEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-1401
Mailing Address - Country:US
Mailing Address - Phone:602-258-9955
Mailing Address - Fax:602-258-9933
Practice Address - Street 1:2200 N 3RD ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-1401
Practice Address - Country:US
Practice Address - Phone:602-258-9955
Practice Address - Fax:602-258-9933
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-31
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZA221768207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ153388Medicaid
AZ153388Medicaid
AZF66658Medicare UPIN