Individual
RUSSELL C BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1221 LEE STREET GROUND FLOOR, CHARLOTTESVILLE, VA 22908-0001
(434) 924-2706
(434) 924-9068
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
0101246345
VA
207T00000X
Neurological Surgery Physician
2003-00551
NC
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
0101246345
VA
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
2003-00551
NC
390200000X
Student in an Organized Health Care Education/Training Program
0116015767
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5916309
—
NC
05
—
NC1494
—
SC
Enumeration date
08/06/2007
Last updated
02/15/2018
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