Individual
GARY BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9601 TOWNLINE RD, MINOCQUA, WI 54548
(715) 358-1255
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5777
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
31704
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31652100
—
WI
Enumeration date
08/31/2006
Last updated
07/08/2007
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