Individual
MR. A JACKSON BAILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
507 MULBERRY HEIGHTS RD, POMEROY, OH 45769-9573
(740) 992-3279
(740) 992-6740
Mailing address
507 MULBERRY HEIGHTS RD, POMEROY, POMEROY, OH 45769-9573
(740) 992-3279
(740) 992-6740
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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