Individual
BENJAMIN BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
(540) 981-7000
Mailing address
320 ODOM RD, RUTLEDGE, TN 37861-4386
(865) 922-3406
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101285469
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2022
Last updated
05/07/2025
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