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Individual

ETHAN BAILEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
4665 N US HIGHWAY 31, COLUMBUS, IN 47201-8558
(812) 376-9353
(812) 376-3757
Mailing address
703 TRENT DR, GREENWOOD, IN 46143-7424

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10003274A
IN
363AS0400X
Surgical Physician Assistant
10003274A
IN

Other

Enumeration date
10/06/2016
Last updated
09/11/2025
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