Individual
JOHN RUSSELL BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
125 QUEENS RD STE 200, CHARLOTTE, NC 28204-3578
(704) 343-9800
(704) 347-2011
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 343-9800
(704) 347-2011
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35578
NC
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
35578
NC
207RI0011X
Interventional Cardiology Physician
35578
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7912610
—
NC
05
—
N3578
—
SC
Enumeration date
07/11/2005
Last updated
07/21/2023
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