Individual
MAC GENE BAILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
100 HOYLMAN DR, GASSAWAY, WV 26624-9321
(304) 364-1060
Mailing address
1431 CENTERPOINT BLVD, SUITE 100, KNOXVILLE, TN 37932-1984
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
1100
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0041340000
—
WV
Enumeration date
01/04/2007
Last updated
07/09/2007
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