# GARY W BAILEY DO PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164611836
- **Authorized official:** GARY WILLIS BAILEY (PHYSICIAN/OWNER)
- **Authorized official phone:** (616) 957-2410

## Contact information

- **Practice address:** 2525 BURTON ST SE, GRAND RAPIDS, MI 49546
- **Practice address phone:** (616) 957-2410
- **Practice address fax:** (616) 957-2411
- **Mailing address:** 2525 BURTON ST SE, GRAND RAPIDS, MI 49546-4834
- **Mailing address phone:** (616) 957-2410
- **Mailing address fax:** (616) 957-2411

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 5101007477 | MI | Yes |

## Other

- **Enumeration date:** 10/18/2007
- **Last updated:** 06/19/2018