Provider Demographics
NPI:1275738486
Name:BAILEY, JASON M (DO)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:M
Last Name:BAILEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1500 N OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BOLIVAR
Mailing Address - State:MO
Mailing Address - Zip Code:65613-3011
Mailing Address - Country:US
Mailing Address - Phone:620-704-4745
Mailing Address - Fax:417-328-6632
Practice Address - Street 1:1165 N BUTTERFIELD RD
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:MO
Practice Address - Zip Code:65613-1056
Practice Address - Country:US
Practice Address - Phone:417-328-6055
Practice Address - Fax:417-328-6632
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025006913207RC0200X
KS05-36693207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201086210AMedicaid
OK200508990AMedicaid