Individual
JEFFREY W BAILET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
248 MCHENRY ST, BURLINGTON, WI 53105-1828
(262) 767-8000
Mailing address
N3293 VIA CASSIO, LAKE GENEVA, WI 53147-5113
(262) 245-5747
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
46488
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34684300
—
WI
Enumeration date
11/16/2006
Last updated
07/08/2007
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