Provider Demographics
NPI:1245383686
Name:BAILEY CHIROPRACTIC CLINIC PC
Entity type:Organization
Organization Name:BAILEY CHIROPRACTIC CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:RODNEY
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:256-464-9067
Mailing Address - Street 1:4072 SULLIVAN ST STE D
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-1732
Mailing Address - Country:US
Mailing Address - Phone:256-464-9067
Mailing Address - Fax:256-464-9160
Practice Address - Street 1:4072 SULLIVAN ST STE D
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-1732
Practice Address - Country:US
Practice Address - Phone:256-464-9067
Practice Address - Fax:256-464-9160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1229111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALU18680Medicare UPIN
ALU23665Medicare UPIN
ALU85811Medicare UPIN