Individual
MR. A JACKSON BAILES
Active
Individual
MR. A JACKSON BAILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3385T891
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0149736000
—
WV
05
—
0391446
—
OH
01
—
31127012900
OHIO BUREAU OF WORKMENS C
—
01
—
3112701294001
ANTHEM BLUE CROSS BLUE SH
—
01
—
410022337
PALMETTO GBA RAILROAD MED
—
01
—
4664951
AETNA
—
01
—
4851990001
ADMINISTAR FEDERAL
—
01
—
993607
CLARITY VISION
—
01
—
OH3385
EYEMED VISIONCARE
—
Enumeration date
09/27/2005
Last updated
01/07/2010
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