NPI 1720155914 · live from the CMS NPI Registry
Jeffery Martin Bailes, PA-C
Physician Assistant in Marietta, OH. National Provider Identifier 1720155914, active.
NPI record
| NPI | 1720155914 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 215 5th St, Marietta, OH 45750 |
| Practice phone | 740-376-4341 |
| Mailing address | 703 Harpold Ave, Ravenswood, WV 26164 |
| Enumerated | November 30, 2006 |
| Last updated | August 6, 2012 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant primary | 363A00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.