Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 051619 | GA |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 51619 | GA |
N | 207VG0400X | Gynecologist | 051619 | GA |
NPI | 1851471486 |
---|---|
Provider Name | Dr. Jason S. Bailey |
First Address | Atlanta, GA 30374-2616 |
Second Address | Gainesville, GA 30501-3822 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 07/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I14132 | (02) | GA |