Individual
JEFFERY MARTIN BAILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
215 5TH ST, MARIETTA, OH 45750-4033
(740) 376-4341
Mailing address
703 HARPOLD AVE, RAVENSWOOD, WV 26164-1339
(304) 440-4344
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
11/30/2006
Last updated
08/06/2012
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