Provider Demographics
NPI:1285612069
Name:BAILEY, AUSTIN G JR (MD)
Entity type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:G
Last Name:BAILEY
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:2695 ROCKY MOUNTAIN AVE
Mailing Address - Street 2:STE 150
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-8702
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2695 ROCKY MOUNTAIN AVE
Practice Address - Street 2:STE 110
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-8702
Practice Address - Country:US
Practice Address - Phone:970-624-4420
Practice Address - Fax:970-624-4459
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2014-02-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CODR-27197207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01271972Medicaid
COCE9978Medicare PIN
CO01271972Medicaid