Individual
MICHAEL SCOTT BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
207 SPARKS AVE STE 402, JEFFERSONVILLE, IN 47130-3739
(502) 587-8000
(502) 587-8001
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2018
KY
363A00000X
Physician Assistant
TC415
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10003290A
LICENSE
IN
05
—
7100383320
—
KY
01
—
PA2018
LICENSE
KY
Enumeration date
09/01/2015
Last updated
08/30/2021
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