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Individual

ERICA L BAILEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
100 MALLARD CREEK RD STE 395, LOUISVILLE, KY 40207-5167
(502) 895-9421
(502) 899-5762
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
45212
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001404100
FL
05
5917585
NC
Enumeration date
10/13/2006
Last updated
02/15/2022
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