Provider Demographics
NPI:1740340579
Name:BAILEY, JUDY L (MD)
Entity type:Individual
Prefix:DR
First Name:JUDY
Middle Name:L
Last Name:BAILEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26351 PATRIOTS WAY
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19947-2575
Mailing Address - Country:US
Mailing Address - Phone:302-933-3000
Mailing Address - Fax:302-934-1145
Practice Address - Street 1:26351 PATRIOTS WAY
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947-2575
Practice Address - Country:US
Practice Address - Phone:302-933-3000
Practice Address - Fax:302-934-1145
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0003187207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
BA603945Medicare ID - Type Unspecified
E44134Medicare UPIN