Provider Demographics
NPI:1952694697
Name:BAILEY, MARY ALICE ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY ALICE ELIZABETH
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22720 BUCKSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MC CALLA
Mailing Address - State:AL
Mailing Address - Zip Code:35111-2711
Mailing Address - Country:US
Mailing Address - Phone:205-481-8640
Mailing Address - Fax:
Practice Address - Street 1:22720 BUCKSVILLE RD
Practice Address - Street 2:
Practice Address - City:MC CALLA
Practice Address - State:AL
Practice Address - Zip Code:35111-2711
Practice Address - Country:US
Practice Address - Phone:205-481-8640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.32084207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALLICENSE #: MD.32084OtherALABAMA BOARD OF MEDICAL EXAMINERS
ALACSC#: ACSC.32084OtherALABAMA BOARD OF MEDICAL EXAMINERS
ALACSC#: ACSC.32084OtherALABAMA BOARD OF MEDICAL EXAMINERS