Provider Demographics
NPI:1992870380
Name:BAILEY, JOHN ANTHONY (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ANTHONY
Last Name:BAILEY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4343 W NEWBERRY RD
Mailing Address - Street 2:STE 6
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-2817
Mailing Address - Country:US
Mailing Address - Phone:352-547-2373
Mailing Address - Fax:352-291-0231
Practice Address - Street 1:4881 NW 8TH AVE
Practice Address - Street 2:STE 2
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4582
Practice Address - Country:US
Practice Address - Phone:352-547-2373
Practice Address - Fax:352-291-0231
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2013-09-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME 95069207LP2900X, 207LA0401X
SC15078207LA0401X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207LA0401XAllopathic & Osteopathic PhysiciansAnesthesiologyAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAL292YMedicare PIN