Individual
DR. SUZANNE M BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
100 MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
(503) 569-1008
Mailing address
2478 13TH ST SE, SALEM, OR 97302-2546
(503) 362-2481
(503) 375-8700
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD161218
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500655210
—
OR
Enumeration date
03/31/2009
Last updated
09/19/2019
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