Provider Demographics
NPI:1215984208
Name:BAILEY, BILL J (DC)
Entity type:Individual
Prefix:
First Name:BILL
Middle Name:J
Last Name:BAILEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6630 S MCCARRAN BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-6136
Mailing Address - Country:US
Mailing Address - Phone:775-829-0177
Mailing Address - Fax:775-829-7741
Practice Address - Street 1:6630 S MCCARRAN BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6136
Practice Address - Country:US
Practice Address - Phone:775-829-0177
Practice Address - Fax:775-829-7741
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB120111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV36453Medicare ID - Type Unspecified
U13707Medicare UPIN