Provider Demographics
NPI:1063565737
Name:BAILEY, RAHN KENNEDY (M D)
Entity type:Individual
Prefix:
First Name:RAHN
Middle Name:KENNEDY
Last Name:BAILEY
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:433 BOLIVAR STREET
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112
Mailing Address - Country:US
Mailing Address - Phone:504-568-6004
Mailing Address - Fax:504-568-6006
Practice Address - Street 1:478 SOUTH JOHNSON STREET
Practice Address - Street 2:7TH FLOOR
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112
Practice Address - Country:US
Practice Address - Phone:504-412-1580
Practice Address - Fax:504-412-1530
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH97682084F0202X, 2084P2900X, 2084P0800X, 2084P0802X, 2084P0805X
NC2015-006962084F0202X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
No2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain Medicine
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136504104Medicaid
LA1667102Medicaid