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Individual

DR. THOMAS BAILEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
175 PHILPOTT LN, BEAVER, WV 25813-9501
(304) 254-9262
Mailing address
175 PHILPOTT LN, BEAVER, WV 25813-9501
(304) 254-9262

Taxonomy

Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
17538
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001718055
WV BCBS
WV
01
1053229
WV DWC
WV
01
17538
LICENSE
WV
05
1801525000
WV
Enumeration date
01/04/2006
Last updated
10/31/2023
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