Provider Demographics
NPI:1972217727
Name:BAILEY JR, JOACHIM JR
Entity type:Individual
Prefix:
First Name:JOACHIM
Middle Name:
Last Name:BAILEY JR
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1870 BARNETT CT W
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43227-3777
Mailing Address - Country:US
Mailing Address - Phone:614-369-9985
Mailing Address - Fax:
Practice Address - Street 1:1870 BARNETT CT W
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43227-3777
Practice Address - Country:US
Practice Address - Phone:614-369-9985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care