Organization
BAILEY FAMILY PRACTICE CENTER, P.A.
Active
Other names
family medical practice
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEODORE GEORGE BRNA JR. M.D. (PRESIDENT)
(252) 235-4181
Entity
Organization
Contact information
Practice address
6321 DEANS ST, BAILEY, NC 27807-8641
(252) 235-4181
(252) 235-2950
Mailing address
6321 DEANS ST, P. O. BOX 280, BAILEY, NC 27807-8641
(252) 235-4181
(252) 235-2950
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
38590
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0159H
BLUE CROSS
NC
01
—
5610052
VIRIGINIA MEDICAID
NC
05
—
89159H
—
NC
01
—
CM4727
RAILROAD MEDICARE GROUP
NC
Enumeration date
03/16/2006
Last updated
05/08/2008
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