Individual
AUDREY KATHRYN BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
40 LARK DR, GRENADA, MS 38901-9640
(166) 280-9245
Mailing address
40 LARK DR, GRENADA, MS 38901-9640
(662) 809-2450
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
904839
MS
Other
Enumeration date
08/27/2021
Last updated
08/27/2021
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