Provider Demographics
NPI:1427277755
Name:BAILEY, AMY ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:ELIZABETH
Last Name:BAILEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1960
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72403-1960
Mailing Address - Country:US
Mailing Address - Phone:870-934-5102
Mailing Address - Fax:870-932-3608
Practice Address - Street 1:1150 E. MATTHEWS
Practice Address - Street 2:SUITE 101
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401
Practice Address - Country:US
Practice Address - Phone:870-972-5937
Practice Address - Fax:870-972-0104
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-5364208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5H019OtherBLUE CROSS
AR07110012800OtherQUAL CHOICE
AR165456001Medicaid
AR07110012800OtherQUAL CHOICE