Provider Demographics
NPI:1699714733
Name:BAILEY, JOHN H III (DO)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:H
Last Name:BAILEY
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:600 WESLEY WAY
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-9413
Mailing Address - Country:US
Mailing Address - Phone:814-332-4595
Mailing Address - Fax:814-332-4590
Practice Address - Street 1:600 WESLEY WAY
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-9413
Practice Address - Country:US
Practice Address - Phone:814-332-4595
Practice Address - Fax:814-332-4590
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS004788L207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA112711N6HMedicare PIN
PA0009958900005Medicaid
PAE02326Medicare UPIN