Individual
JARED BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
777 HOSPITAL WAY, POCATELLO, ID 83201-5175
(208) 239-1000
Mailing address
2265 EAST SUNNYSIDE ROAD, IDAHO FALLS, ID 83404-7598
(208) 542-5000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
M12844
ID
2085R0204X
Vascular & Interventional Radiology Physician
Primary
M12844
ID
Other
Enumeration date
05/09/2009
Last updated
06/09/2020
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