Provider Demographics
NPI:1396730552
Name:BAILEY, BILLY DEAN (MD)
Entity type:Individual
Prefix:
First Name:BILLY
Middle Name:DEAN
Last Name:BAILEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:854 W. JAMES CAMPBELL BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401
Mailing Address - Country:US
Mailing Address - Phone:931-388-9706
Mailing Address - Fax:931-388-9772
Practice Address - Street 1:125 AUGUSTA AVE
Practice Address - Street 2:SUITE A
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-5515
Practice Address - Country:US
Practice Address - Phone:270-534-0046
Practice Address - Fax:270-534-0048
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY26804207RR0500X
TN16622207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
145768OtherHEALTHLINK
KY000000049267OtherBLUE CROSS BLUE SHIELD
18D0700362OtherCLIA
029602OtherHEALTH ALLIANCE
145768OtherHEALTHLINK