Individual
JASON BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1001 E PRIMROSE ST, SPRINGFIELD, MO 65807
(417) 875-3462
Mailing address
1001 E PRIMROSE ST, SPRINGFIELD, MO 65807-5155
(417) 875-3462
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
201910205
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200070248
—
MO
Enumeration date
03/04/2014
Last updated
08/08/2019
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