Provider Demographics
NPI:1558453357
Name:BAILEY MEDICAL ASSOCIATES, PC
Entity type:Organization
Organization Name:BAILEY MEDICAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:H
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:III
Authorized Official - Credentials:DO
Authorized Official - Phone:814-332-4595
Mailing Address - Street 1:600 WESLEY WAY
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-9413
Mailing Address - Country:US
Mailing Address - Phone:814-333-8832
Mailing Address - Fax:814-333-8830
Practice Address - Street 1:600 WESLEY WAY
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-9413
Practice Address - Country:US
Practice Address - Phone:814-333-8832
Practice Address - Fax:814-333-8830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS004788L207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA038831Medicare PIN
PAEO2326Medicare UPIN