Individual
JIMMIE DALE BAILEY II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 E JOHNSON ST, HOLYOKE, CO 80734-1854
(970) 854-2500
(970) 854-3887
Mailing address
1001 E JOHNSON ST, HOLYOKE, CO 80734-1854
(970) 854-2500
(970) 854-3887
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DR.0065419
CO
207Q00000X
Family Medicine Physician
MD. 22758
AL
207Q00000X
Family Medicine Physician
ME 125949
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000188171
—
CO
01
—
DR.0065419
CO LICENSE NUMBER
CO
Enumeration date
10/03/2005
Last updated
06/27/2022
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