Provider Demographics
NPI:1992462683
Name:BAILEY, MELVIN L II
Entity type:Individual
Prefix:MR
First Name:MELVIN
Middle Name:L
Last Name:BAILEY
Suffix:II
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 1:240 E APACHE ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74106-3702
Mailing Address - Country:US
Mailing Address - Phone:918-794-0197
Mailing Address - Fax:918-794-0196
Practice Address - Street 1:240 E APACHE ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74106-3702
Practice Address - Country:US
Practice Address - Phone:918-794-0197
Practice Address - Fax:918-794-0196
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-17
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist