Provider Demographics
NPI:1932209541
Name:BAILEY, DEBORAH (PT)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 S SHADES CREST RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-3551
Mailing Address - Country:US
Mailing Address - Phone:205-987-6501
Mailing Address - Fax:205-987-6503
Practice Address - Street 1:3421 SOUTH SHADES CREST RD
Practice Address - Street 2:SUITE 107
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-3551
Practice Address - Country:US
Practice Address - Phone:205-987-6501
Practice Address - Fax:205-987-6503
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH1821225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51537941OtherBLUE CROSS BLUE SHIELD AL
AL51537926OtherBLUE CROSS BLUE SHIELD AL