Individual
DR. JUSTIN BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 KENTON DR, SUITE 100, CHARLESTON, WV 25311-1263
(304) 346-5533
(304) 346-5611
Mailing address
300 KENTON DR, SUITE 100, CHARLESTON, WV 25311-1263
(304) 346-5533
(304) 346-5611
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20410
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001706175
BLUE CROSS FOR GROUP
WV
01
—
1447349238
NPI NUMBER FOR GROUP
WV
05
—
3810001081
—
WV
01
—
DC7713
UMWA NUMBER FOR GROUP
WV
01
—
P00189318
UMWA PIN NUMBER FOR GROUP
WV
01
—
P00215125
RAILROAD MEDICARE NUMBER FOR GROUP
WV
Enumeration date
01/14/2006
Last updated
08/07/2013
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