Provider Demographics
NPI:1881901189
Name:BAILEY VEIN INSTITUTE, LLC
Entity type:Organization
Organization Name:BAILEY VEIN INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:COLIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:573-302-0032
Mailing Address - Street 1:1075 NICHOLS RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:OSAGE BEACH
Mailing Address - State:MO
Mailing Address - Zip Code:65065-3093
Mailing Address - Country:US
Mailing Address - Phone:573-302-0032
Mailing Address - Fax:573-302-0378
Practice Address - Street 1:64-1035 MAMALAHOA HWY
Practice Address - Street 2:SUITE K
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-8440
Practice Address - Country:US
Practice Address - Phone:808-885-4401
Practice Address - Fax:808-885-4412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI156762086S0129X, 202K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebologyGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty