Individual
JEFFREY D BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
5319 HOAG DR, SHEFFIELD VILLAGE, OH 44035-1494
(440) 930-6050
(440) 934-8882
Mailing address
PO BOX 790309, SAINT LOUIS, MO 63179-0309
(636) 549-2380
(314) 569-5974
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN165192
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0918672
—
OH
01
—
617230
BCBS
OH
01
—
P00764395
MEDICARE RAILROAD
OH
Enumeration date
09/14/2005
Last updated
03/10/2010
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