NPI 1497095244 · live from the CMS NPI Registry
Jacob Shumway Bailey, OD
Optometrist in Alamogordo, NM. National Provider Identifier 1497095244, active.
NPI record
| NPI | 1497095244 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 1124 10th St, Alamogordo, NM 88310 |
| Practice phone | 575-434-1200 |
| Mailing address | 2043 College Way, Forest Grove, OR 97116 |
| Enumerated | February 14, 2013 |
| Last updated | March 28, 2018 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist | 152W00000X | ODP-100283 (TX) |
| Optometrist primary | 152W00000X | 697 (NM) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.